Biden says pandemic is over
September 19, 2022 8:16 PM   Subscribe

Politico: Biden's "60 Minutes" remarks surprised his own health advisers, and came as the administration seeks more Covid response funding.

Also, the administration should be encouraging people to get the latest shot.
posted by NotLost (373 comments total) 15 users marked this as a favorite
 
He undercut the entire basis for the student loan forgiveness boondoggle. It was because of the pandemic emergency. Now the Republicans can claim the move is literally illegal.
posted by JohnnyGunn at 8:24 PM on September 19, 2022 [13 favorites]


Thank you for calling this out specifically. It's making me lose my mind. It's like, we have enough problems, unforced errors are really something we can't afford.
posted by bleep at 8:33 PM on September 19, 2022 [27 favorites]


Now the Republicans can claim the move is literally illegal.

I mean, they could always claim that. I'm not sure worrying about what the republicans might do or say is a particularly winning strategy - you'll only tie your own hands, not theirs.

This is spectacularly bad idea because the disease is absolutely still circulating and mitigations are still sensible - the discussion that is relevant is about balance of harms, and this pronouncement makes it very difficult to have that conversation.
posted by Dysk at 8:33 PM on September 19, 2022 [58 favorites]


Sorry in advance for the aside but can we add the uspol tag on this so the filter can do its thing? Or is it too late?
posted by bxvr at 8:38 PM on September 19, 2022 [10 favorites]


(Also, 'healthy people no longer need to restructure their lives to avoid catching it' is quite different to 'the pandemic is over'. HIV/AIDS is widely considered an ongoing pandemic, for example.
posted by Dysk at 8:44 PM on September 19, 2022 [39 favorites]


Is the pandemic (basically, for healthy people)over? Yup.

Not so much? 3000 people are still dying of covid every week. THIS is the CDC's current map of "community transmission levels", which are still high in most of the country (defined as >100 cases/100K population and/or >10% test positivity rate).
posted by Pseudonymous Cognomen at 8:51 PM on September 19, 2022 [53 favorites]


Is the pandemic (basically, for healthy people)over? Yup.

On what basis do you make that statement? The literal definition of a pandemic is "prevalent over a whole country or the world." That does, in fact, describe Covid, no matter how much you might personally want to be done with it. I personally know several "healthy" people who've been infected with it at outdoor events recently despite being vaccinated and overall very careful. As noted above, hundreds of people a day are still dying from it; it's one of the top 10 causes of death.

The neat thing about Covid is that once you get it as an, as you put it, healthy person, you have a chance of being turned into a non-healthy person via long Covid. We don't know what that number is but it seems to be somewhere between 1-5%. How many times do you want to play that lottery?

And honestly, your "for healthy people" comes across as being happy to sacrifice the non-healthy people at the alter of YOLO having fun, which isn't really a good look.
posted by Candleman at 8:59 PM on September 19, 2022 [107 favorites]


Biden says pandemic is over

Narrator: it wasn't, in fact: over.
posted by alex_skazat at 9:01 PM on September 19, 2022 [56 favorites]


Not so much? 3000 people are still dying of covid every week. THIS is the CDC's current map of "community transmission levels", which are still high in most of the country (defined as >100 cases/100K population and/or >10% test positivity rate).

NPR did a piece a few days ago that surprised me, it coming from NPR, sharing the idea that there's some debate about what counts as a COVID death:
The debate over COVID's mortality rate hinges on what counts as a COVID-19 death. Gandhi and other researchers argue that the daily death toll attributed to COVID is exaggerated because many deaths blamed on the disease are actually from other causes. Some of the people who died for other reasons happened to also test positive for the coronavirus.
[...]
If deaths were classified more accurately, then the daily death toll would be closer to the toll the flu takes during a typical season, Doron says. If this is true, the odds of a person dying if they get a COVID infection — what's called the case fatality rate — would be about the same as the flu now, which is estimated to be around 0.1%, or perhaps even lower.
I thought it was an interesting article, but maybe not a helpful article, to the extent there are multiple conflicting claims to sort out, some coming from government sources you'd hope might be more coordinated amongst themselves.
posted by mph at 9:03 PM on September 19, 2022 [8 favorites]


It's not over.

pan·dem·ic
(of a disease) prevalent over a whole country or the world.

Is 3,000 deaths/week (US) indicative of something that's "over"?
Does 500,000 new cases/week (US) look like it's "over"?

It's not over.
posted by pt68 at 9:04 PM on September 19, 2022 [10 favorites]


The neat thing about Covid is that once you get it as an, as you put it, healthy person, you have a chance of being turned into a non-healthy person via long Covid. We don't know what that number is but it seems to be somewhere between 1-5%

Probably more like 20-30%, and one study found up to 50% still experiencing symptoms after six months.
posted by Pseudonymous Cognomen at 9:06 PM on September 19, 2022 [28 favorites]


so stupid
posted by eustatic at 9:08 PM on September 19, 2022 [3 favorites]


Probably more like 20-30%, and one study found up to 50% still experiencing symptoms after six months

Isn't that press release claiming 20% of the 40% of adults in the population who have had Covid? So ... more like 8%? That's what it goes on to say in the first bullet point as well (7.5%).

An NIH preprint says 3.69% of all cases.
posted by mph at 9:15 PM on September 19, 2022 [7 favorites]


NPR did a piece a few days ago that surprised me, it coming from NPR

I am much more surprised to see an infectious disease specialist quoted as saying that "most people have enough immunity either from being vaccinated or having had covid" when coronaviruses don't work that way, reinfection is possible, and there is no such thing as lasting immunity, not to mention the issue of breakthrough infections with existing vaccines, which have proven less efficacious against emerging variants (hence the need for omicron-targeted boosters).
posted by Pseudonymous Cognomen at 9:17 PM on September 19, 2022 [18 favorites]


Isn't that press release claiming 20% of the 40% of adults in the population who have had Covid?

Obviously, since you can't get long covid without having first had covid? I don't understand why you're talking about the relative percentage of the total population, when the percentage of covid cases that develop long covid is the relevant part of that.
posted by Pseudonymous Cognomen at 9:19 PM on September 19, 2022 [12 favorites]


It's utterly obnoxious (and displays a deep ignorance of public health) to focus on Covid death as the only bad outcome of concern.

Likewise, it's utterly disingenuous to claim Covid death rates are over-reported when testing effort, accuracy, and reporting are worse in the US than since the earliest days of the pandemic.

Finally, amateur words to minimize the ongoing disaster are demonstrably ableist, classist, and racist, not to mention insulting to the healthcare workers who are collapsing at their posts while headed into a very ugly and deadly winter.

For example: In age- and sex-adjusted analyses, African American individuals (RR, 3.54; 95% CI, 1.38-9.07; P = .008) and Hispanic individuals (RR, 4.68; 95% CI, 1.28-17.20; P = .02) were the most likely to test positive for COVID-19. Asian American individuals had the highest risk of intensive care unit admission
posted by SaltySalticid at 9:20 PM on September 19, 2022 [25 favorites]


Obviously, since you can't get long covid without having first had covid? I don't understand why you're talking about the relative percentage of the total population, when the percentage of covid cases that develop long covid is the relevant part of that.

Sorry ... I went into your comment thinking "percentage chance of anyone having long Covid," so yes ... point taken. You obviously were talking about people who have had Covid on re-read.
posted by mph at 9:26 PM on September 19, 2022 [5 favorites]


Finally, amateur words to minimize the ongoing disaster are demonstrably ableist, classist, and racist, not to mention insulting to the healthcare workers who are collapsing at their posts while headed into a very ugly and deadly winter.

What are "amateur words?"
posted by mph at 9:27 PM on September 19, 2022 [5 favorites]


Sorry, for those unfamiliar, Miriam Webster says an amateur is:

I am not sure what or who your "amateur words" comment was directed at of the several sources linked and several comments made in this post/thread.
posted by mph at 9:37 PM on September 19, 2022 [1 favorite]


"On what basis do you make that statement? The literal definition of a pandemic is "prevalent over a whole country or the world."

Look outside. Whether our technical description of what constitutes a pandemic is right or wrong, the vast majority of people have returned to a precovid life.
posted by Keith Talent at 9:39 PM on September 19, 2022 [7 favorites]


I assume (and agree) that Biden was the one with the "amateur words". He's not an expert and he should let the experts speak on this subject. And he should realize his amateur words end up sounding like Official US Government Policy.

Look outside. Whether our technical description of what constitutes a pandemic is right or wrong, the vast majority of people have returned to a precovid life.

I lived a totally normal life through the entire AIDS pandemic thanks to my various privileges. That doesn't mean it wasn't a pandemic.
posted by mmoncur at 9:42 PM on September 19, 2022 [53 favorites]


The vast majority of people have returned to a precovid life.

Because they are living as though the pandemic is over, that doesn't mean that the pandemic has actually passed. Wishful thinking doesn't make anything so. And it certainly doesn't stop anyone from getting sick, let alone die. In fact, acting as if it's over prematurely is what prolongs the pandemic.
posted by NotLost at 9:43 PM on September 19, 2022 [51 favorites]


Look outside. Whether our technical description of what constitutes a pandemic is right or wrong, the vast majority of people have returned to a precovid life.

I can go out in a downpour in shorts and a t-shirt instead of wearing a raincoat and carrying an umbrella, but ignoring the weather doesn't make it go away.
posted by Pseudonymous Cognomen at 9:44 PM on September 19, 2022 [48 favorites]


This frustrates me as well. I had wondered for a long time whether we'd take away from living through this pandemic that it was a good idea to, say, avoid the common cold by routinely masking on airplanes. Or masking in crowded public places during flu season. I thought, "We're going to learn how effective masking and hand-washing can be, and we're going to de-stigmatize wearing masks in public*, and we're going to carry that forward and reduce our burden of these other highly contagious diseases." lol. Me and my cock-eyed optimism.

*When I was about 25 years younger than I am now, I had a condition that required me to wear a surgical style mask in public. I was verbally assaulted at least once by someone who thought I was carrying a disease that was a threat to them. So that was bad.

Until I learned more about coronaviruses during the pandemic, I didn't realize that the common cold is caused by about five different (IIRC) coronaviruses that circulate, and that we don't actually become permanently immune to every strain of cold we get. I knew cold viruses mutated, and I guess I thought all my life that we'd catch a cold, get over it, develop immunity, and never get that particular cold again, and that the viruses mutated so constantly that it was possible to catch 1-3 of them a year. Imagine my surprise!

Covid has been tearing through my friend circle since things opened up earlier this summer. These tend to be fully-vaccinated people, and their cases tend to be mild, but it really shows how vulnerable we still are. Some of them aren't able to identify where they picked it up. Others caught it at small, outdoor events that they felt pretty safe at.
posted by Well I never at 9:59 PM on September 19, 2022 [25 favorites]


I think he basically said what much of the country was already thinking.

Covid is still here, in fact I've known more people personally who've gotten Covid this summer than I did in the first whole year of the pandemic. Including myself.

I ended up getting Covid after a long-haul flight back in July (which is something I certainly wouldn't have done a year or two ago, so it's not entirely surprising; I very literally bought my ticket and took my ride). One of my friends got it on the same trip. All throughout the summer there was always someone in my ~100 person work team who was "out on quarantine" after testing positive. It's just become A Thing That Happens, not an extraordinary event.

And whether the result of mutations which have increased transmissibility but decreased pathogenicity, or because most (not stupid) people have now been vaccinated multiple times, and increasingly have access to advanced antiviral treatments, the experience of having Covid isn't the same. I mean, I've had colds that were worse. (Hell, I've had hangovers that were worse.) But that's presumably due in large part to the two vaccines and the course of Paxlovid I started taking almost immediately, and which I'm very grateful to have had.

I'm suspicious of the effect this must be having on the statistics, too. Someone like me won't be included in any official statistics about Covid. I took an at-home Covid test, tested positive, got a hand-wavey prescription for Paxlovid over the phone, picked up the meds, and took the week off from work. AFAICT nobody was really collecting data at any stage of that process. I guess you could count Paxlovid prescriptions, but lots of people just gut it out for a few days longer and don't bother getting an antiviral. I even tried to report myself as a case (via the COVID-specific notification app I installed a year ago), but the app won't take reports from at-home tests. So that was that. It seems like the only people reliably getting in the stats anymore are people who end up hospitalized with Covid, or who go to one of the dwindling number of official testing stations (and the only people I know who have done that, recently, are people who needed it for international travel).

I think the most likely endgame, at this point, is that Covid antibodies will get added to annual flu vaccines, and it'll just be something that lurks around the edges of human existence, a sort of "background radiation" that's still killing people, but not at a high-enough rate or in demographic spectra that cause significant public alarm.

I'm not sure that's in Biden's power to change. Trying to convince the public that Covid is still something worth worrying about, once they have decided (and are being regularly told by Fox News et al) that it's much less important than INFALATION!!111!, is just going to make him look out-of-touch. He can only direct the conversation so far, particularly among voters who may not be primed to think very highly of him from the outset.

And TBH, de-politicizing the issue might actually be for the best. Covid is likely to be a public-health issue for years to come; it's something that needs to be managed by state and local health departments and other agencies, maybe with Federal coordination and resources, but balanced against other priorities. Given the uneven distribution of Covid, there are some areas that are going to decide (not wrongly) that there are higher, more life-saving priorities than Covid outreach at some point, if they have not already. Some places probably need to look at "post-Covid" or "long Covid" outreach rather than trying to squeeze more blood from the "go get vaccinated" stone, too. (Been a while since I've heard of anyone's opinion on vaccines being changed; pretty sure if someone has decided to be an anti-vaxxer at this point, they're probably going to ride that train to the end of the line.)
posted by Kadin2048 at 10:01 PM on September 19, 2022 [53 favorites]


All of the above, about life being back to normal, be that as it may, this is still a pandemic. We might also decide not to cancel an outdoor event because we can deal with water falling from the sky just fine, but that is also not the same thing as "it isn't raining".
posted by Dysk at 10:17 PM on September 19, 2022 [2 favorites]




We've chosen to learn nothing from this and do nothing to prevent the next major infectious disease. Thousands dying a week and we can't be bothered anymore.

Great job, everyone. No notes.
posted by fifteen schnitzengruben is my limit at 10:22 PM on September 19, 2022 [29 favorites]


As a child we called this “Oregon sunshine.” The notion being that during some periods of the year in western Oregon it rains endlessly day after day and eventually you accept that a light drizzle is actually a sunny day.
posted by interogative mood at 10:24 PM on September 19, 2022 [17 favorites]


Mod note: I've deleted the snarky "dictionary says" comment about "amateur." In general, let's try to not fall into petty squabbles here (ie, a) it's not that hard to parse "a non-expert's words" from what was written; b) it's not that hard to just say "I meant words from a non-expert"). It's a tough topic, but we should be able to discuss it without filling the thread with useless bickering. Please apply some effort. Thank you!
posted by taz (staff) at 10:46 PM on September 19, 2022 [36 favorites]


Long COVID Experts and Advocates Say the Government Is Ignoring 'the Greatest Mass-Disabling Event in Human History'

I appreciate this link. The article felt pretty comprehensive and explained the stakes. It was frustrating, too, because at a few points there are sentiments around the complexities of the associated political problems. My mind goes down two tracks at the same time:

I'm frustrated over the political history of Covid (both official political behavior from assorted institutions and informal political/cultural behavior from individuals). Some of my frustration is just an indulgence at this point -- an invitation to ruminate on a past I can't change. Some of my frustration is not knowing what I could do differently, were this Groundhog Day, to affect any of it.

And I'm frustrated with what is yet to come, because one note they hit in that link a few times is how collectively primed our institutions and leaders seem to be to simply move on.

I helped someone who worked for me navigate treatment and leave for a chronic illness with our relatively friendly HR department, and it was a bureaucratic pain that involved me being her outboard brain on the days she couldn't advocate for herself or parse the many requests for documentation or the sometimes exasperated benefits person. Securing the benefits and help was just hard -- hard on the person navigating the system, hard on the people who very much want to help but have to work within the parameters of the system, and hard on the relationship between me and that person because there was a lot of "no, bring me a different rock" built into the process when it came to getting doctors to say the right words to unlock the right parts of the bureaucratic process.

It was upsetting enough to know that is going on with a cluster of things that were common and normal enough before Covid, and now it's even more upsetting to think about it happening at the scale that article implies, knowing that a portion of the population administering any benefits or help we might squeeze out of our sputtering, gridlocked institutions are carrying around with them significant doubt that anything ever even happened over the past couple of years, quietly asking themselves "how could this be that bad when I staked my sacred honor on averring that that wasn't that bad."

And it's even bigger-picture frustrating to know that the adversarial, hostile elements of the system are all indications that it is working as designed, to benefit the people it is meant to benefit at the expense of the people suffering. That under a different design we would not have to treat every novel thing to come along as a novel thing if we had different presumptions around how care is supposed to work, and how we're supposed to get it.
posted by mph at 10:55 PM on September 19, 2022 [17 favorites]


Epidemiologist Gregg Gonsalves, Eric Topol and others have some choice words.
posted by spamandkimchi at 11:07 PM on September 19, 2022 [14 favorites]


Also just read this insightful essay by medical anthropologist Nora Kenworthy, What a decade of ‘ending AIDS’ can teach us about the politics of pandemic end-games
It’s clear, of course, that the reasons for declaring an ‘end’ to the COVID pandemic are political, not epidemiological. Many experts and activists have pointed out the hypocrisy and danger of these policy positions, and the powerful political interests driving them. In the US, pollsters and political consultants have pushed heavily for policies and rhetoric that ‘normalize’ the pandemic and retrench what few public health protections were still in place. These political positions risk abandoning vulnerable Americans, as well as those in many lower income countries, to continued suffering. Such abandonment under the guise of declarations of success is, sadly, familiar to many of us in the global health field.

I will never forget the first time I heard that AIDS was ‘ending ‘ in 2011. I had just returned from more than a year in Lesotho’s HIV clinics, where patients were still struggling to access treatment and adult HIV prevalence rates were above 40% in some areas. Lesotho had only begun rolling out a comprehensive HIV treatment program in 2008, heavily subsidized by international donors. Many patients still faced long waits and inadequate support for treatment. But within three short years, powerful leaders and donors were already celebrating “the beginning of the end of AIDS.”
posted by spamandkimchi at 11:08 PM on September 19, 2022 [12 favorites]


The pandemic part may be actually because Covid has moved on to be endemic. Now we have all have to live with it, and perhaps forever or, at least, for a long time.
posted by bz at 11:25 PM on September 19, 2022 [8 favorites]


I actually think the covid death rate is an UNDER count. I know too many people who have died from post-covid strokes, heart attacks and sudden liver failure as young previously healthy adults.

The head of Indianapolis-based insurance company OneAmerica said the death rate is up a stunning 40% from pre-pandemic levels among working-age people.

“We are seeing, right now, the highest death rates we have seen in the history of this business – not just at OneAmerica,” the company’s CEO Scott Davison said during an online news conference this week. “The data is consistent across every player in that business.”


“Even more distressing, explains Davison, is that this is not some demographic anomaly with the eldest members of our society passing on. The 40% rise in death rates is consistent for working-class folks 18 to 64-years-old. “Just to give you an idea of how bad that is, a three-sigma or 200-year catastrophe would be a 10% increase over pre-pandemic levels.”
posted by Bottlecap at 11:26 PM on September 19, 2022 [38 favorites]


I can't speak to the US, but I think the covid pandemic in the UK is basically ended. What covid is now is endemic - permanently present with relatively predictable levels of infection. We're not seeing the huge waves of infection spread any more, despite the government and then population having largely given up on infection control, just a steady (lower) state of new infections. Being endemic doesn't mean covid is not dangerous. Of course the risk of long covid, and indeed death, still remains, and will blight lives, much more so than flu. But like flu, heart disease or road deaths, a certain level of casualties is quietly considered socially and politically acceptable, and now covid has joined that, whether we like it or not.

Covid was never going to be 'over'.
posted by Absolutely No You-Know-What at 11:34 PM on September 19, 2022 [13 favorites]


My level of rage around all of the handling of the pandemic is so incandescent and deep that I fear if I peer into it anymore, it will engulf me entirely. I am already a shell of my former self, having lost nearly all faith in the decency of humanity.

It is not over. Not for anyone. Not for me. Not for you. Not even fucking close.
posted by Crystalinne at 11:51 PM on September 19, 2022 [70 favorites]


There's so much that could be done to fight this disease. It requires money, and commitment, and education.

Covid could be over, if we treated it seriously. It's not impossible. It requires winning over those who have been lied to and bought those lies, which is not an easy thing, but we need to deal with the fascists anyway, so add it to the list. I despair for all the lives that will continue to be lost or the people disabled while we choose to do nothing more. I despair for all those who cannot safely exist in public.

I am filled with a deep despair that I fear I will never be able to put down.

China proves that this disease can be controlled, and they are doing it while the rest of the word refuses to take it seriously. We are sacrificing more than we realize in doing so.

At the very least we need new standards for ventilation in publicly accessible buildings. We could do so much with just that.
posted by vibratory manner of working at 11:57 PM on September 19, 2022 [22 favorites]


MISSION ACCOMPLISHED
posted by chavenet at 12:10 AM on September 20, 2022 [33 favorites]


China proves that this disease can be controlled

There are currently 60 million people in lockdown in China. 60 million! Two years into the pandemic!

I think it will be decades before we know if the social and economic damage (not to mention the increasingly draconian nature of the Chinese surveillance state) is ultimately a better policy than the rest of the world has taken.

It requires money, and commitment, and education

As the China example shows, it also requires coercion backed by state violence.
posted by gwint at 12:11 AM on September 20, 2022 [70 favorites]


Also, this post contains the words I wish I could find.
We will not trade disabled deaths for abled life. We will not allow disabled people to be disposable or the necessary collateral damage for the status quo. We will not look away from the mass illness and death that surrounds us or from a state machine that is more committed to churning out profit and privileged comfort with eugenic abandonment. - You Are Not Entitled To Our Deaths, by Mia Mingus

posted by Crystalinne at 12:13 AM on September 20, 2022 [25 favorites]


Japan's had per-capita numbers that have generally been very good by rich country standards, but also it's still very much the norm to have a mask on when you're out of your home.* Apparently Japan's per-capita new-day infection numbers recently outranked, say, the US, but this was because Japan got an infection wave while the US (or at least US reporting) was in a trough. I do occasionally find myself thinking, though, about how the single occupation most affected by the (ongoing) pandemic was "line cook," with something like, what, 40%? 60%? increased mortalities above baseline.

*The main exception to this has been kids — schools and daycares have been a huge problem in Japan, due to some combination of "they are kids" and "lax enforcement," to the point where I saw a stat a month or two ago that fully one third of all new covid cases in Japan have been in patients under 20 years old. Given the shape of Japan's population pyramid, this is particularly noteworthy. Also particularly worrying, given that pediatric covid seems to cause things like hepatitis, among many other long-term issues.
posted by DoctorFedora at 12:36 AM on September 20, 2022 [8 favorites]


There's so much that could be done to fight this disease. It requires money, and commitment, and education.

Fighting an endemic disease is different than a pandemic. For example, much greater emphasis on anti-virals (paxlovid etc), especially for the vulnerable, possibly as a prophylactic for people at risk of exposure (medical staff etc). Booster vaccines, and continued research into a universal vaccine that would also work better against mutations, and of course continued efforts to get people to take vaccines in the first place.

You'd have hoped that wearing masks in public when e.g. you have a cold would have become normalised in the west, but that ship appears to have sailed (and then caught on fire and sunk) alas.

For long covid, that means a much higher emphasis on post-infection care, access to rehab, and a much better social safety net; you would hope that this would also mean better recognition and help for e.g. ME/CFS and other disabling but hard to diagnose conditions. Further research and investment in treatment for long covid, whether it's apheresis or tackling micro blood clots or whatever proves to be effective.

Transferring to a different stage of managing this disease, recognising that it's now a different type of problem is not giving up on it. Whether such action *actually* happens though... well, I wish I had greater belief that it would.
posted by Absolutely No You-Know-What at 12:53 AM on September 20, 2022 [12 favorites]


I know this is a US thread, but as someone living in the US, I would very much like to hear more about how other parts of the world are addressing covid these days.
posted by aniola at 1:06 AM on September 20, 2022 [10 favorites]


I think we're mostly not, to be honest (India). Official numbers are way down, ditto recorded deaths (emphasis on official and recorded). Mask wearing has dropped to near nil except at certain indoor places or a few mandated areas (though it's not stigmatized or judged like it appears to be in the US). Covid has very much gone away from general discourse as well, from omg pandemic to yet another illness that we just deal with and move on.
Not at all sure we learnt the right lessons but that's where we're at.
posted by Nieshka at 1:13 AM on September 20, 2022 [9 favorites]


I think it will be decades before we know if the social and economic damage (not to mention the increasingly draconian nature of the Chinese surveillance state) is ultimately a better policy than the rest of the world has taken.

There's real social and economic damage that we are suffering from based on the policy that we have chosen, on top of the lives and the mass disablement. I'd certainly never claim that China hasn't made more than their share of mistakes, on top of being, you know, China. But the mere fact of "it doesn't have to be this way" is one that I find powerful. We can choose other models. I'd much rather point to Australia and New Zealand than China, but they both gave up a long time ago. It would have been very useful to see how they fared in the longer run if they hadn't.
posted by vibratory manner of working at 1:30 AM on September 20, 2022 [4 favorites]




I know this is a US thread, but as someone living in the US, I would very much like to hear more about how other parts of the world are addressing covid these days.

South Africa. I'm sitting in a path care clinic right now waiting for my husband to be tested for Covid.

We don't have easy access to tests, they are expensive and inconvenient. We don't have access to real n95 masks at all. We don't have access to paxlovid. We don't have access to the latest version of the vaccine, just the old Pfizer.

Hardly anyone is masking and people's lives seem to have gone back to normal in terms of socialising, attending indoor events etc.

Apparently we are going into a new wave of infections, although predictions are that it will be mild, whatever that means.

Many people I know are vaccine hesitant or non committal, don't feel any urgency about it.

Many people I chat to don't believe Covid is real, whatever that means.

We don't have the same extreme politicisation of mask wearing as I see mentioned here by USA people. But most people see them as an unnecessary inconvenience.

As far as I can tell, the most accurate data we have is in testing waste water. Numbers mean nothing as most people are nor getting tested.
posted by Zumbador at 2:14 AM on September 20, 2022 [16 favorites]


We're not seeing the huge waves of infection spread any more [...] just a steady (lower) state of new infections.

You're forgetting the UK survey that tests people selected at random.

2022 contains 3 peaks of waves of infection so far, from three different variants. They happen to have similar heights. They're higher than caused by the previous variants of concern. They might be higher than the first narrow peak in 2020.

Predictions vary. But let's not assume Summer 2023 will be free of variant-driven waves of infection.

From the linked page, you have to look at ICU or deaths to talk about a lower steady state. Or, look elsewhere for the subset of covid hospital beds which are considered "primarily covid".

At this point, I'm not convinced about reducing overall infections. Immunity wanes; vaccine-only immunity wanes quicker. R0 - the R number before immunity - is probably north of 6.

It's not just that only authoritarian China achieves R0 less than 1. (Temporarily, in an effort to eliminate covid). It's that if you can't get close enough to 1, you can't get much benefit.

In the simplest model, the equilibrium point is where immunity = 1-1/R0. If you halve R0 from 6 to 3, that shifts from 83% to 66%. So for that heroic effort, you only reduce infections by a fifth.
posted by sourcejedi at 2:32 AM on September 20, 2022 [11 favorites]


Yeah, COVID has not moved to endemic status in the UK - the numbers are still variable and highly prone to peaking. The media just don't report it much, because there aren't enough deaths for them to care (and any other consequences are ignored).
posted by Dysk at 2:38 AM on September 20, 2022 [8 favorites]


I would very much like to hear more about how other parts of the world are addressing covid these days.

Just to add to the comments above from the UK. There are literally no controls left in place in the UK. I am typing this on a train. No one is wearing a mask. I suspect no one has even considered wearing a mask, including me, as that has normalised back to zero as a thing that people do. There are no limits on going to shops or anywhere else. Rounds of vaccination continue.
posted by biffa at 3:25 AM on September 20, 2022 [6 favorites]


On the "social death" of Covid: Why did Covid disappear from our collective consciousness so quickly? It's a few months old but obviously still relevant.

I think this bodes poorly for our collective ability to deal with other serous issues, like climate change. People seem to deeply believe that the biosphere owes them the standard of living they've become accustomed to, when that simply isn't the case.
posted by swr at 4:05 AM on September 20, 2022 [27 favorites]


Clickbait. Biden does a lot more hedging in the actual comment, but only the “over” part makes the quote cut, sans context. Fauci said something quite similar back in April about how the US is “out of the pandemic phase.”

Biden makes plenty of real gaffes, but Politico remains “Tiger Beat on the Potomac.”
posted by aspersioncast at 4:59 AM on September 20, 2022 [17 favorites]


Another often overlooked casualty of COVID is loss of smell and taste. In December 2019, I had an ear sinus infection that resulted in a complete loss of smell and taste. Not fun at all especially if you love to cook, eat and drink wine. I had previously lost my sense of smell and taste from 2014-2016 due to severe depression. Through the help of a wonderful therapist I regained them only to lose them again.
posted by DJZouke at 5:17 AM on September 20, 2022 [4 favorites]


I would very much like to hear more about how other parts of the world are addressing covid these days

Here in Germany, masks are still required in limited circumstances (public transport, doctors' offices, hospitals, care homes, etc.) Otherwise, you still see a sprinkling in supermarkets etc., but only a sprinkling, and even in public transport it's a lot more half-assed than it was. The Federal Government has extended this to Easter, and given the state governments the option to add further measures like masks in shops, restaurants, etc. or obligatory testing etc.

There is generally a sense most that people don't care all that much anymore though. I'm not sure how willing people will be to abide by any further measures, given how half-hearted they are about masks even in public trasnport where it's still obligatory. And I mean, the top two headlines in my local newsite's Covid section are "Fulda is planning a pre-pandemic style Carnival" and "Cases are increasing"...
posted by scorbet at 5:17 AM on September 20, 2022 [8 favorites]


I certainly agree with all the people saying "this isn't over." My wife and I own a yarn shop in a tourist town and are one of the last non-healthcare facilities in town still requiring customers to wear masks. But we're making the switch this week. We'll still be wearing our N95s, but customers will be allowed to choose for themselves. We'll be running air filters appropriate to our square footage, but we're still going to have to keep our masks on pretty much all day, which is annoying, but we don't want to get Covid (and we haven't so far).

We do have to deal with the reality that most people are not wearing masks into stores and more and more of them balk when you ask them to. We don't want people to perceive us as unfriendly or unwelcoming, and we've gotten pretty confident that our own masks do a good job of keeping us safe in all kinds of environments. We don't like policing people, and retail is hard enough without adding potential conflict. So even though continuing to ask everyone to mask would be ideal, we don't live in an ideal world.

I think Biden's comment comes from the same place. It's the sort of unguarded answer that also led to marriage equality. He's accepting the reality of people's behavior as well as the reality of the virus. This isn't over indeed, but we all have to live with the majority of people living like it IS over. We can't pretend their actions aren't driving policy, right or wrong.
posted by rikschell at 5:21 AM on September 20, 2022 [12 favorites]


As if we needed another reason to stop taking this thing seriously...
posted by drstrangelove at 5:27 AM on September 20, 2022 [2 favorites]


swr--- I said this early on in the pandemic. The fact that a large swath of our population doesn't even take the threat of a pandemic seriously (even as people were dying around them) then they are never going to be convinced that climate change is a threat to our species. Forest fires, record heat waves and droughts, record floods elsewhere, record cold snaps (Feb 2021) , etc, etc and all you get is "meh, it's just the weather."
posted by drstrangelove at 5:30 AM on September 20, 2022 [4 favorites]


I'm still waiting for my fucking gold star from the CDC.

Getting back to normal isn't good enough. It's not over until we have a public health system that has enough resources to handle the next pandemic. It's not over until we have a robust social safety net which provides everyone with paid leave. I's not over until there's a memorial covid wall on every town green. It's not over until all essential workers are properly compensated for their work and receive the respect they deserve. And it's not over until there are REAL CONSEQUENCES for Trump, Kushner, Abbott, DeSantis, etc.

Why is that so hard?
posted by RonButNotStupid at 5:30 AM on September 20, 2022 [12 favorites]


The pandemic part may be actually because Covid has moved on to be endemic. Now we have all have to live with it

Covid is not endemic, and endemic does not mean "it's here forever", I wrote up a bit about what 'endemic' means in a previous comment here if anyone wants to know and not use it wrong.
posted by SaltySalticid at 5:33 AM on September 20, 2022 [16 favorites]


I would very much like to hear more about how other parts of the world are addressing covid these days.

Malaysia reporting. Here's the official ministry subsite. We're clearly in some kind of endemic phase, there's not much sense of political urgency about it (such as encouraging people to take the fourth shot/second booster), but the numbers looked 'tolerable'. We're even allowed to unmask in public and indoors as policy, but crucially private operators eg business owners are allowed to dictate mask usage. So on the one hand people are more lackadaisical because you won't get literally fined but on our own volition everyone still masks everywhere. We're just more chill when we're dining out - it also helps because of the tropical weather the built environment aren't all closely contained boxes, so some kind of ventilation improvement can happen. But actual Malaysians are still mainly masking and obsessed with air quality but really it's because it coheres with our established cultural values anyway (being particular about 'fresh air'; always having a fan around; used to masking; easy access to sun exposure), so you have buildings and malls flexing on their air quality protocols.

But this is in active duel with the antivax and horse paste people, which, like a lot of non-Western places, aren't always Christian or GOOPy but also from reflexive anti-colonial; pro-China; anti-semitic places as well. That said, I AM SO GLAD my organisation's administrative side is mainly Malaysian located in a Malaysian building because my expat colleagues truly had some screwy moments when it became acceptable to unmask indoors.
posted by cendawanita at 5:38 AM on September 20, 2022 [19 favorites]


Another often overlooked casualty of COVID is loss of smell and taste.

Exactly. The 8-year old son of a colleague came down with COVID and nearly a year on he still hasn't recovered his sense of smell/taste. It's anyone's guess whether this is going to be permanent at this stage. Yet the media only focuses on deaths as if there aren't a hundred things COVID can do to a person. Early in the pandemic a professor at one of our state universities (who is in his 40s) was severely ill for months after contracting COVID on a trip to the UK. He had a blood clot that very nearly cost him his leg and the last I heard he's dealing with possible permanent liver damage.
posted by drstrangelove at 5:44 AM on September 20, 2022 [5 favorites]


Well my father has covid right now. He is in a LTC facility with severe parkinsonian dementia (in Ontario, Canada). 17 other vulnerable seniors in his wing and 3 staff members also have covid. It's the worst outbreak they have had in the facility since he went in around Nov 2021. He is now in isolation in his room without the ability to understand why.

I'm not a big fan of anybody right now.

I think people have missed the darker truth of letting covid-19 rip which is that it is extremely likely you and the people you ostensibly love will die of covid-19 (3rd leading cause of death last week). If you and yours are healthy right now maybe it won't be this year or the next but it will be there waiting for you the moment you become vulnerable. Maybe you won't die from not being able to breathe. Maybe you won't be put on a respirator. If you lucky in your bad luck maybe you stroke out or have a heart attack that takes you out quick either during or shortly after your infection. Or maybe you just get your progression towards death accelerated via diminished lung function or mental capacity.

This is what we collectively chose when we allowed those who prioritized brunch to determine the pandemic response of western society and we did this very stupid thing mostly before we all got infected with a disease that causes brain fog! I'm not really looking forward to seeing what a culture of dumber people with shorter and less healthy lives produces. I suspect it will be even more impoverished and vicious than our current Logan's Run style choices.
posted by srboisvert at 5:58 AM on September 20, 2022 [56 favorites]


I stand by the fact that if COVID had happened during some other less monstrous President's term in the US, perhaps things would have turned out better. Perhaps.

There is such an air of casualness now to this virus; "oh everyone will get it at some point and then at least you're done" (what about reinfections, hoss?), "you're vaxxed and healthy so you'll be fine" (you don't know that), "I mean, what do we do, stop living?" (literally no one said that, but you can give a shit about others).

If we couldn't get our shit together for COVID, I have no doubt we are absolutely fucked when a much more dangerous virus emerges...and it will.
posted by Kitteh at 6:26 AM on September 20, 2022 [17 favorites]


I took an at-home Covid test, tested positive, got a hand-wavey prescription for Paxlovid over the phone, picked up the meds, and took the week off from work. AFAICT nobody was really collecting data at any stage of that process.

Minus the Paxlovid, that was the same for me. I didn't make an effort to report my own case (because I was sick and at the time it felt like too much effort to take on), so my case and cases like mine aren't included in any of the statistics. I have wondered how the long covid studies are trying to account for this enormous gap between reported cases and actual cases, especially since there isn't a US equivalent to the UK random population testing to provide an accurate baseline.

I can't speak to the US, but I think the covid pandemic in the UK is basically ended. What covid is now is endemic - permanently present with relatively predictable levels of infection. ... But like flu, heart disease or road deaths, a certain level of casualties is quietly considered socially and politically acceptable, and now covid has joined that, whether we like it or not.

Sidestepping the definition arguments around "endemic" and so on, this description sounds similar to attitudes where I live. Clearly the current level of infection and death is politically (if not morally) acceptable, and I think it is vanishingly unlikely to see any increase in mandated measures going forward, barring a return to a much more deadly situation.

You'd have hoped that wearing masks in public when e.g. you have a cold would have become normalised in the west, but that ship appears to have sailed (and then caught on fire and sunk) alas.

I'm in a fairly politically liberal city surrounded by very conservative rural areas, and I still see a fair bit of masking out in public -- maybe 10 or 15% of the people at the grocery store, for example. So it hasn't gone to zero here and doesn't seem to be stigmatized, but it also isn't very prevalent or at a high enough level to make a difference in population-level cases. I would guess that in places like here, you will see that low level of masking continue for some years to come, but probably slowly dwindling to a very low baseline level.
posted by Dip Flash at 6:48 AM on September 20, 2022 [3 favorites]


“We still have a problem with Covid. We’re still doing a lot of work on it. But the pandemic is over.”

Would anyone think twice if they were told this was a Trump quote? May we someday be released from the "leadership" of these pathetic, know-nothing, vainglorious old men.
posted by dusty potato at 6:58 AM on September 20, 2022 [18 favorites]


Look, I just want to be able to go to a diner again. When I can feel like I'm not risking other people's lives by eating pancakes with bad coffee in public, then the pandemic is over.
posted by Flight Hardware, do not touch at 7:02 AM on September 20, 2022 [24 favorites]


aniola: "I know this is a US thread, but as someone living in the US, I would very much like to hear more about how other parts of the world are addressing covid these days."

Chile: most people have 4 shots. You need proof of vaccination to enter restaurants. Kids still wear masks in school. You still need a mask in closed public spaces, buses etc. There's some noise about relaxing the vaccination requirement.
Personally, I'm planning to reevaluate my masking procedure (ie: always in public closed spaces and crowded open spaces) sometime in 2026 or 2027 if things seem to be improving.
posted by signal at 7:16 AM on September 20, 2022 [24 favorites]


Clearly the current level of infection and death is politically (if not morally) acceptable, and I think it is vanishingly unlikely to see any increase in mandated measures going forward, barring a return to a much more deadly situation.

And that's essentially what Biden meant -- that the pandemic as a crisis was over. You may or may not agree with that, but it looks like majority of Americans agree with him. There aren't going to be lock-downs, mask mandates, or all the infrastructure of a crisis. It's going to be "live with it."

this enormous gap between reported cases and actual cases

There's another implication to this that I haven't seen made, which is that cases are really 4-5 times higher than reported (or even more), then the fatality rate really has gone down immensely.
posted by Galvanic at 7:28 AM on September 20, 2022 [9 favorites]


As an immunocompromised person... you know what? Fuck it. It's fine. Whatever.

You want to write off anyone with a weakened immune system, anyone vulnerable, the elderly, fine. You want us to die for the economy? Fucking fine. But let's be honest about it.

Bring on the suicide booths.

If the government can throw the weak to the wolves, at least let's do it with some compassion. We let people with terminal diseases suffer for weeks and months, begging for death, in enormous pain, because all life is sacred and we can't just kill people because they're sick. But that's a lie, and now it's a really, really obvious lie. All life isn't sacred, and we'll gladly sell out our most vulnerable citizens for pocket change.

As the long term effects of this pandemic keep spreading throughout our society, we're going to see more and more people incapacitated, unable to work, unable to think, unable to function. There are no safety nets in place for them; no health insurance, a ridiculously cruel disability system, no welfare. Imagine being homeless with long covid. I mean, seriously imagine it.

As a society, we've declared that our economy is more important than the lives of our weakest members. We have decided to sacrifice people like me to economic progress. If we're going to do that, let's at least be honest about it. Let's be humane. If you want us to die, give us the means to do so peacefully.

If you're going to kill us, at least do it nicely.
posted by MrVisible at 7:35 AM on September 20, 2022 [56 favorites]


this enormous gap between reported cases and actual cases


Reminder that wastewater viral count is a much better measure of disease activity these days.

Currently, it's as high as the winter 2021 Delta surge, and has been that way all summer.

I'm very disappointed that every single public action has always been to ratchet caution down. Like someone above, I'd hoped that masking would stay on airplanes, but ...

My life has contracted substantially because so many people feel the need to spew their breath freely at all costs including death and disability, and I absolutely resent it, bitterly.
posted by Dashy at 7:39 AM on September 20, 2022 [27 favorites]


I think this bodes poorly for our collective ability to deal with other serous issues, like climate change.

I think our demonstrated inability to deal with climate change already boded poorly for any pandemic. Tomato/tomato*.


* Don't get me wrong, it's definitely 'tomato'.
posted by pompomtom at 7:41 AM on September 20, 2022 [3 favorites]


Is Biden's declaration that the pandemic is "over" (I know that's not what he said, but politicians are savvy and are generally aware of how their statements will be summarized/interpreted) worth pissing off everyone for whom the pandemic definitely isn't "over"?

Like what was the point of doing this? Okay, most Americans have decided that the pandemic is over and moved on. Do any one of them really care that Biden said this? Are there really people who think more of Biden because he took his mask off and said the pandemic is over because there are certainly lots of people who think less of him for making such a statement!

Yeah, this is politicking, and to be fair Biden did hedge a lot. But Democrats always seem to have a knack for completely unnecessary politicking that doesn't gain new supporters and only pisses off their core constituency.
posted by RonButNotStupid at 7:50 AM on September 20, 2022 [11 favorites]


Also, didn't Biden learn anything from the past two years? Wasn't he the one who promised that if everyone got vaccinated, things could be back to normal by July 4th (2021) only for omicron to hit?
posted by RonButNotStupid at 7:55 AM on September 20, 2022 [5 favorites]


Reminder that wastewater viral count is a much better measure of disease activity these days.

Yes. The wastewater counts, the UK population surveys, and anecdotal evidence (from a comment above: "Covid has been tearing through my friend circle since things opened up earlier this summer.") all point to the actual case count being very high. Reported cases are a smaller portion of that; that seems like it would make studies about, say, the prevalence of long covid much more difficult.

NPR did a piece a few days ago that surprised me, it coming from NPR, sharing the idea that there's some debate about what counts as a COVID death:

This reminds me (and is mentioned in the article) of the way in which the "hospitalized" metric became progressively less informative as it started to include more and more people who were hospitalized for another cause but then tested positive for covid as part of the admission process. But the back and forth of the experts in the article seems to make it clear that the jury is still out on this.
posted by Dip Flash at 7:55 AM on September 20, 2022 [3 favorites]


> And TBH, de-politicizing the issue might actually be for the best.

On what basis should we conclude that this latest effort by Democrats to unilaterally disarm is going to go any better than the thousands of others? And when has the accuracy of a political attack ever mattered to the Republican politicians or their followers?

Meanwhile, this suggestion the administration is just trying to capitalize on natural conditions of the electorate ignores the fact that the administration created some of those conditions. The CDC's attempt to capitalize on anti-mask sentiment prior to the delta and omicron waves is just one prominent example of how difficult it's been for municipal and state leaders to hold the line on measures designed to protect their residents.

People talk all the time about how policy must be evidence-based, but where's the evidence that these cynical attempts to race to rush to the front of a crowd that's marching somewhere are providing any political benefit whatsoever?
posted by tonycpsu at 7:56 AM on September 20, 2022 [5 favorites]


Is Biden's declaration that the pandemic is "over" (I know that's not what he said, but politicians are savvy and are generally aware of how their statements will be summarized/interpreted) worth pissing off everyone for whom the pandemic definitely isn't "over"?
Looking at the polling, https://projects.fivethirtyeight.com/coronavirus-polls/ , I am going to say the answer is "Yes." His approval numbers on the C19 handling among independents could be better, and the proportion of the population that are "Not Very Worried" is rising while "Very Worried" is falling.
posted by 3j0hn at 8:05 AM on September 20, 2022 [2 favorites]


As a society, we've declared that our economy is more important than the lives of our weakest members

We made that declaration a long time pre-covid.
posted by Galvanic at 8:15 AM on September 20, 2022 [6 favorites]


We made that declaration a long time pre-covid.

And Covid put a spotlight on that decision and we had probably our best chance ever to revisit it (a public health emergency, a supply chain in crisis, thousands dying from all walks of life, people lining up for food banks, public health infrastructure in crisis) and instead we again chose to do absolutely nothing two Senators from West Virginia and Arizona chose to do absolutely nothing.
posted by RonButNotStupid at 8:25 AM on September 20, 2022 [8 favorites]


Looking at the polling, https://projects.fivethirtyeight.com/coronavirus-polls/ , I am going to say the answer is "Yes." His approval numbers on the C19 handling among independents could be better, and the proportion of the population that are "Not Very Worried" is rising while "Very Worried" is falling.

With respect: so?
posted by Gadarene at 8:27 AM on September 20, 2022


Looking at the polling, https://projects.fivethirtyeight.com/coronavirus-polls/ , I am going to say the answer is "Yes." His approval numbers on the C19 handling among independents could be better, and the proportion of the population that are "Not Very Worried" is rising while "Very Worried" is falling.

I am absolutely convinced that the Biden administration believes that electoral success for Democrats depends on eliminating COVID-19 safety precautions and "getting back to normal" and I'm not as certain as I wish I were that they're wrong. The last couple of years have been completely demoralizing as even my generally cynical view of other people has been repeatedly shown to be impossibly naively optimistic.
posted by Pope Guilty at 8:34 AM on September 20, 2022 [4 favorites]


Biden...'s accepting the reality of people's behavior...

Yes. When he said he'd follow the science, that included political science.
posted by doctornemo at 8:41 AM on September 20, 2022 [2 favorites]


I would very much like to hear more about how other parts of the world are addressing covid these days.

This is subject to change with the cooler weather here in Austria per person per month we receive 5 "gurgel" PCR test tubes which we fill with water. We then gargle that water for 30 seconds spit it back in the tube, close it off, label it with a QR code sticker and then drop the testtubes off at the local supermarket. The samples are batch tested and within 24 hours we receive answers by sms / email. If you are positive you then get sent the legal information re mandatory isolation etc and are then linked with healthcare services etc.

Per head we also receive a pack of 10 antigen tests per month. N95 masks are still mandatory in medical contexts and there is a firm 5-10% wearing them on public transport and in indoor public places. I am pretty sure they will be required on public transport again soon.
posted by pipstar at 8:44 AM on September 20, 2022 [13 favorites]


I know this is a US thread, but as someone living in the US, I would very much like to hear more about how other parts of the world are addressing covid these days.

The pandemic phase certainly feels "over" in Scotland. Obviously the disease hasn't gone away but deaths are now very low: Covid was an underlying or contributory cause of just 4-5% of deaths in August, and the majority were aged 75+.

Masking is essentially over: still required in hospitals, doctors', and pharmacies but nowhere else. In supermarkets, people wore masks for a couple of weeks after the legal requirement ended, then almost entirely stopped. Testing is over. Paxlovid is only available on the NHS for people with the highest-risk existing conditions.

Virtually all of my friends have had it now: experiences ranged from "one sleepless night" (myself) to "very bad cold for two weeks" (immunocompromised friend).

We don't have the same polarisation and party-political division on Covid as America. To be honest I think most people here see that Covid will never go away, any more than colds and flu will, and it's now a lot less dangerous than flu (on an individual fatality rate basis, for all age groups, and 3-10x less dangerous for 20-40s). And no one wore masks or stopped socialising for a bad winter flu season, so...
posted by Klipspringer at 8:44 AM on September 20, 2022 [8 favorites]


People talk all the time about how policy must be evidence-based

The evidence I've been seeing all summer is: the pandemic is over. If we go by behaviours and the choices people are making, then we need to accept that many people simply don't review whatever data you want to put out there. Many people are not mindful of the science of pandemics. I suppose a lot of people who post to this space may be looking at some forms of evidence, but how people choose to live their lives is also evidence.

I get the feeling some people are stuck on how the world is just not acting the way it should. Up to a point, fine. But from what I see, the world is a certain way and this is a battle I'm not fighting. Live how you must, change what you can. I caught COVID-19 at the beginning when we were all fearful and very cautious, I caught a later variant when I was *foolish enough* to travel by air. The cough lingers over a month later.

Anyhow, I think the question of evidence is interesting.
posted by elkevelvet at 8:47 AM on September 20, 2022 [8 favorites]


"Pandemic is over" is the same as Bush's "Mission Accomplished".
posted by mfoight at 9:00 AM on September 20, 2022 [10 favorites]


In my liberal town, definitely the majority of Democrats are ready to "go back to normal." The only people with an appetite for stronger Covid protocols are a small number of high-information high-compassion voters. I happen to think they're correct, but correct has never won elections. Biden knows that Republicans will be quick to exploit any potential weakness, and as much as I hate it, I think he's playing the game to win here, and I think that's what he has to do.
posted by rikschell at 9:00 AM on September 20, 2022 [5 favorites]


“We still have a problem with Covid. We’re still doing a lot of work on it. But the pandemic is over.”

Would anyone think twice if they were told this was a Trump quote? May we someday be released from the "leadership" of these pathetic, know-nothing, vainglorious old men.


I would like some actual proof that they are "still doing a lot of work on it". Near as I can tell the Democratic Party is just saying things while every aspect of the pandemic response gradually grinds to a halt.

Near as I can tell the only work being done on covid now is being done by the democratic party political consultants triangulating in order to capture the votes of people who are kind of middling on covid. You know them: the people who are okay with allowing other people to die from it as long as it is not them or their friends.

I personally am not thrilled to have my health now and in the future be a mandatory campaign contribution to the DNC even though I consider them the lesser of two bloody awful evils.
posted by srboisvert at 9:10 AM on September 20, 2022 [11 favorites]


Are there really people who think more of Biden because he took his mask off and said the pandemic is over

I mean, yeah. To an extent, anyway. Nobody is going to put down their MAGA hat or take the Let's Go Brandon bumper sticker off their car over this, but plenty of nominal democrats will probably take this as reassuring and encouraging, since it's what they'd like to hear.
posted by We put our faith in Blast Hardcheese at 9:11 AM on September 20, 2022 [1 favorite]


Is case rate a good measure any more? Given that a high percentage of people are vaccinated, most of those can safely tolerate an infection. If you look at the death rate, it's been basically flat (in the US) since June. That is the longest period without a major swing in numbers since the pandemic began.

Note: I'm not arguing it's over, but that certain metrics might be more or less useful at this point.
posted by CheeseDigestsAll at 9:29 AM on September 20, 2022 [3 favorites]


> The evidence I've been seeing all summer is: the pandemic is over. If we go by behaviours and the choices people are making, then we need to accept that many people simply don't review whatever data you want to put out there. Many people are not mindful of the science of pandemics. I suppose a lot of people who post to this space may be looking at some forms of evidence, but how people choose to live their lives is also evidence.

It's a lot different for random citizens on the street or responding in polls to say the pandemic feels over to them than it is for the President of the United States to announce that it's over when he has a lot of pending executive action, including but not limited to student loan relief, that was at least in part motivated by and predicated on the pandemic.

I also don't think we'd be seeing so much deference to the sense of the people on an issue like climate change where public opinion has lagged behind scientific consensus for decades.
posted by tonycpsu at 9:40 AM on September 20, 2022 [4 favorites]


If you look at the death rate, it's been basically flat (in the US) since June.

Maybe, sort of. See the weekly figures via the CDC of "all deaths involving COVID-19".

"Involving" is defined as "Deaths with confirmed or presumed COVID-19, coded to ICD–10 code U07.1."

Presumed by whom? Bit of wiggle room there.

Good news is, it's still running behind death involving mere pneumonia.
posted by BWA at 9:41 AM on September 20, 2022 [1 favorite]


Biden knows that Republicans will be quick to exploit any potential weakness, and as much as I hate it, I think he's playing the game to win here

Just fucking awesome to see Democrats join Republicans in denying science when it's politically-expedient to do so. And meanwhile the government has been gaslighting the American public over the severity of covid (there are two maps on the CDC page; the one you see by default is mostly reassuring shades of green, the map of "community transmission levels" that you have to go through a menu to find is red or orange from coast to coast and has been for months), and the CDC has utterly destroyed its credibility by giving politicised and frequently just bad and wrong advice.
posted by Pseudonymous Cognomen at 9:49 AM on September 20, 2022 [12 favorites]


I read some where that he probably mean that the pandemonium was over, that the 'ahhhh ahhh ahhh' running around in panic part.

I dunno if I'd buy that reasoning.
posted by 922257033c4a0f3cecdbd819a46d626999d1af4a at 9:52 AM on September 20, 2022


> Dashy: "Reminder that wastewater viral count is a much better measure of disease activity these days."

One of the weirdest things to me is how few places are doing wastewater testing. For example, in Washington state, it seems that none of the largest counties containing the largest metro areas seem to be doing it (e.g.: none of Seattle, Tacoma, Everett, Olympia, or Spokane areas are doing it). In NY state, it seems only Nassau county is doing wastewater testing (i.e.: most of NYC doesn't seem to be covered). California seems to have pretty good coverage but somehow San Francisco county isn't doing wastewater testing.

If I were in charge of things (which I clearly am not), wastewater testing would be one of the main things I'd be doing. I just don't really get why more places -- especially places I would expect to be doing it like NYC, SF, and Seattle -- aren't.
posted by mhum at 10:02 AM on September 20, 2022 [10 favorites]


Like what was the point of doing this? Okay, most Americans have decided that the pandemic is over and moved on. Do any one of them really care that Biden said this? Are there really people who think more of Biden because he took his mask off and said the pandemic is over because there are certainly lots of people who think less of him for making such a statement!

Random voters probably aren't on his radar as much as his constituents: corporate owners and investors. One of Biden's campaign promises to them was (quoting here) "Nothing will fundamentally change," and he's delivering on it.
posted by dusty potato at 10:14 AM on September 20, 2022 [5 favorites]


Obligatory: Covid is not less dangerous than flu. No matter what else you think about it, I'm begging everyone reading this to consider that this reassuring tidbit isn't true.
posted by bleep at 10:19 AM on September 20, 2022 [26 favorites]


I don't think there's a widely-agreed upon state for "end of a pandemic" for a novel disease that becomes endemic. The only possible definition would be for the death count to fall to zero and stay there, which I don't expect to see in maybe a decade (And this would imply that anyone, dying of any disease, is a pandemic).

Regardless of what Biden wants to do, pretty much every US state has already ended its pandemic restrictions, not that it could enforce them anyway (some did in 2020). The US Congress - the one that passed the biggest climate change bill in history - slashed pandemic funding already.

If you call it a pandemic or not, it seems like we're already not doing anything about it. In that case, what does yelling "it's a pandemic!" do? If we call it a pandemic for the next ten years and no one changes anything about their behavior, the word becomes meaningless. Covid is still out there, if we want to call it a pandemic or not. You should still get vaccinated regularly, isolate when sick, and wear a mask in crowded areas.

Remember the Homeland Security Advisory System? Everyone considered it a joke, we never went below condition yellow "elevated - significant risk of terrorist attacks".
posted by meowzilla at 10:26 AM on September 20, 2022 [7 favorites]


People where I live are still wearing masks. Without messaging, support, or encouragement, they're still doing the right thing. People don't need to be forced. They just need to *be told the truth* & given support. This is what civilization is for. Biden could be saying exactly what he's saying now but still give out free n95s and develop incentives & rewards for wearing them. That would save many people from ruining the rest of their lives for no reason.
posted by bleep at 10:30 AM on September 20, 2022 [8 favorites]


The truth is they don't want them ppl masking because then they can't do facial recognition anymore. That's it.
posted by bleep at 10:31 AM on September 20, 2022 [3 favorites]


Pop quiz. Fill in the blank: Life expectancy declined sharply because of Covid in 2020 and again in 2021, reaching levels not seen since ________.

While you're thinking, I will agree that this was a huge error that will set back the crucial efforts to increase vaccination rates and will probably cost many lives. And any decline in life expectancy is a sign of major problems, and even before the pandemic the US was experiencing stagnation in life expectancy and even declines among many population groups. But the thing is, the answer is 1996, and 2022 will be much better than 2021 (Source) And back then, in the 1990s, things seemed pretty normal; no one was wringing their hands over the huge health crisis, because there wasn't one.

I'm not trying to justify inaction. The needless deaths and other significant health consequences is clearly a tragedy. But I think this simple fact - that we've fallen back, but to a reasonably "normal" level - goes a long way towards explaining people's acceptance of it.
posted by Mr.Know-it-some at 10:40 AM on September 20, 2022 [2 favorites]


Fuck if I know but I didn't invent it.
posted by bleep at 10:52 AM on September 20, 2022


I think we can do better than distilling governmental actions down to one conspiracy-sounding motive. There are obviously many reasons covid has left the forefront of messaging.
posted by tiny frying pan at 10:53 AM on September 20, 2022 [5 favorites]


If masks work & aren't very expensive AND they interfere with a huge program that our government has invested millions of dollars in, who's going to win?
posted by bleep at 10:55 AM on September 20, 2022


In 2022 "that sounds like a conspiracy theory so it probably isn't true" doesn't really suffice.
posted by bleep at 10:56 AM on September 20, 2022


iPhones face rec fine with a mask, I suspect it’s still mainly just that masks make pundits feel bad.
posted by Artw at 11:00 AM on September 20, 2022 [5 favorites]


In 2022 "that sounds like a conspiracy theory so it probably isn't true" doesn't really suffice.

No, really that just sounds like a conspiracy theory.
posted by Dip Flash at 11:02 AM on September 20, 2022 [5 favorites]


If you call it a pandemic or not, it seems like we're already not doing anything about it. In that case, what does yelling "it's a pandemic!" do?

Maybe gets us--the federal and state governments, private entities--to start doing something about it again? I strongly encourage people to read the Gregg Gonsalves tweet thread referenced above, in terms of all the ways in which this proclamation will be affirmatively detrimental to public health efforts.

And I remain gobsmacked at people who think that Biden has no power to shape national dialogue or to make the case for why certain things should be priorities from his bully pulpit. If other people stop treating something as important, that doesn't mean that he has to also. But if HE starts treating something as unimportant, then that's a signal that it's ok to find it unimportant too. It is shockingly irresponsible.
posted by Gadarene at 11:02 AM on September 20, 2022 [3 favorites]


(But there IS more than one reason, so...suffix, suffice, whatever you lice, but pushing ONE reason behind dropping covid messaging sounds like conspiracy theorizing, yes.)
posted by tiny frying pan at 11:02 AM on September 20, 2022


Mod note: One deleted, let's avoid derailing the conversation into the facial recognition part.
posted by loup (staff) at 11:04 AM on September 20, 2022 [2 favorites]


Maybe gets us--the federal and state governments, private entities--to start doing something about it again?

The public is not going to go along with it. This is not the government giving up on something when the public remains committed to it, this is the government essentially following along in the path that a substantial majority of Americans have already decided on. And, no, the bully pulpit is not going to change things -- half the country thinks Biden is Brandon, and a large chunk of the other half. Covid comes in #15th in terms of most important issues for voters in the midterm.

Biden's not saying anything the rest of the country hasn't pretty much already said, and he wouldn't change anybody's mind if he said something different.
posted by Galvanic at 11:11 AM on September 20, 2022 [5 favorites]


If there's more than one reason behind encouraging people not to limit the spread of a mutating, brain-eating, airborne bat virus that's killed a million people in its first 2 years of existence I look forward to finding out what the other one is.
posted by bleep at 11:12 AM on September 20, 2022


Plain old economics, for starters. Not that I agree with it. But this whole thread has tons of reasons discussed.
posted by tiny frying pan at 11:20 AM on September 20, 2022 [2 favorites]


Sorry -- didn't catch the sentence without an end in my previous post:

"and a large chunk of the other half has essentially decided that things are good enough"
posted by Galvanic at 11:22 AM on September 20, 2022 [1 favorite]


The public is not going to go along with it.

The public is not going to go along with funding for increased ventilation in schools or for continued free boosters and tests or for financial relief for people with long COVID?

Curious.
posted by Gadarene at 11:22 AM on September 20, 2022 [6 favorites]


Pretty sure the snippy border guard who told me to take my mask off when I was driving into the States earlier this summer was just being a dick, not actually concerned about the potential that I might be someone else with the same hair, eyes, skin color, general body shape/build, car, and ID documents but an entirely different mouth just pretending to be me in order to enter the country illegally. But nominally it was for the camera.
posted by eviemath at 11:30 AM on September 20, 2022 [2 favorites]


Starbucks says it is ending sick pay for #COVID19 starting October 2, ending paid time off for COVID illness, self-isolation and vaccine side effects.

This is the sort of thing that Biden's announcement encourages and facilitates. It is A-OK with the White House.
posted by Gadarene at 11:48 AM on September 20, 2022 [21 favorites]


And back then, in the 1990s, things seemed pretty normal; no one was wringing their hands over the huge health crisis, because there wasn't one.

I'm not trying to justify inaction


Sure sounds like it? A loss of 2.7 years in life expectancy is significant; it's wiped out the gains made in two decades, and the number of people with long covid means that more people will be spending their final years in worse health.
posted by Pseudonymous Cognomen at 11:50 AM on September 20, 2022 [13 favorites]


(Regularly scheduled reminder that laying out the potential reasons behind something isn't necessarily a justification.)
posted by We put our faith in Blast Hardcheese at 11:51 AM on September 20, 2022 [4 favorites]


I understand that Metafilter is much more Covid-averse than the average person, but this thread IMO is a perfect example of why Biden said what he did. He does not want the Democratic party to be viewed as the party of Covid scolds, and for good reason--the vast majority of the American voting population are not Covid scolds, if they ever were.

People here want us to live like it's a permanent March 2020 and well, that was never, ever going to happen. Then, we had a novel respiratory disease with no vaccine, no pharmacological treatment, no mask supply, and no established course of medical intervention. We now have all of these things.

Is Covid bad? Absolutely. But even in this thread I see both an overreliance on ancedote-as-data (my brother's sister's grandmother's cousin's daughter got Covid and she hasn't been able to smell for two years. Okay, cool story) and conflicting data/interpretations of data.

In my opinion the thing holding us back from getting past the emergency part of Covid is a complete lack of comprehensive data interpreted in a solid and understandable way. For instance: It is over 2.5 years since this started and we are still arguing about the definition of a "Covid death." That is insane.

Perhaps Biden should have said the emergency phase of Covid is over. Because yeah, it is.
posted by rhymedirective at 12:04 PM on September 20, 2022 [41 favorites]


The public is not going to go along with funding for increased ventilation in schools or for continued free boosters and tests or for financial relief for people with long COVID?

I mean...have you been following the news in the US? The public is absolutely NOT going along with these things. "The public" has been showing up to school board meetings to spit on teachers, they do not give a single solitary shit about ventilation. You can't get people to take the first two fuckin' shots--they don't give a goddamn about free boosters! And if "the public" in the US had any interest at all in financial relief for people dealing with chronic illness and disability it would literally be an unrecognizable country to me, a resident of some 40-odd years.
posted by We put our faith in Blast Hardcheese at 12:05 PM on September 20, 2022 [16 favorites]


It is over 2.5 years since this started and we are still arguing about the definition of a "Covid death."

Also interesting that the definition posited in the thread agrees with the anti-vax version, repeated on NPR, in that anyone with COVID who dies is represented as a COVID death, because doctors and medical examiners are apparently lazy and conniving. That's insane.
posted by The_Vegetables at 12:11 PM on September 20, 2022 [5 favorites]


"...anti-vax version ... that anyone with COVID who dies is represented as a COVID death"

There is absolutely no logical connection between being anti-vax and discussing how to interpret Covid death statistics.

I will ignore anyone who denies the overwhelming effectiveness of vaccines, though I think whether to mandate them and whether young children should get them are questions that reasonable people can disagree about.

On the other hand, it's clear that some people who die with Covid didn't die because of Covid, though I have no idea what the magnitude of that effect is, or whether underreporting on the other side is bigger or smaller.
posted by Mr.Know-it-some at 12:19 PM on September 20, 2022 [2 favorites]


It is over 2.5 years since this started and we are still arguing about the definition of a "Covid death." That is insane.

Are we? Because I would think the concept of 'excess deaths' would account for any discrepancies. And since March 2020 the United States has seen 1,105,736 excess deaths, which is slightly higher than the number of reported Covid deaths. [source]

Also, I'll cut right to the chase. The pandemic isn't over until Trump and the Republicans are held accountable for everything they did, full stop. And as long as Republicans are anywhere near gaining power, we're still in the emergency phase of the pandemic.
posted by RonButNotStupid at 12:28 PM on September 20, 2022 [3 favorites]


Are we?

Yes. Even in this very thread!
posted by rhymedirective at 12:31 PM on September 20, 2022 [3 favorites]


Yup, I'm out of this thread. There's a huge gap between being a "COVID scold" who wishes we could all live like it was March 2020 forever (wtf??) and believing that it's irresponsible for the President of the United States to--

You know what? Fuck it. Doesn't matter.
posted by Gadarene at 12:36 PM on September 20, 2022 [13 favorites]


Also, I'll cut right to the chase. The pandemic isn't over until Trump and the Republicans are held accountable for everything they did, full stop. And as long as Republicans are anywhere near gaining power, we're still in the emergency phase of the pandemic.

This sentence carries a good deal of the weight of the current thread.. I just think some people here no longer prioritize COVID-19 in comparison to.. literal fascist coup attempts, dismantling of the electoral system, attacks on reproductive rights, etc. It's like we're talking about a lot more than the "pandemic is over" wording. I don't even live in the US, but the evidence (stares around) is that there are other hills to die on.
posted by elkevelvet at 12:39 PM on September 20, 2022 [4 favorites]


I don’t want permanent March 2020. I want people to wear a freaking mask *so I can stop living like it’s March 2020.* I want better ventilation and UVC in buildings and _structural_ changes so that the world becomes a place where I can exist without risking becoming even more diasbled or DEAD. And whenever covid comes up people ask when I am going back to normal and my answer remains the same - I can not do that until people take some very extraordinarily basic safety precautions so that I can leave my fucking house. But talking about that is met with a wall of “you want us to be in lockdown forever” instead of actually LISTENING and looking at the data about the measures we could take.

For instance, they’re building a new building across the street from me. Why in the last two and a half years have building codes not changed so that the new building will have better and safer ventilation? It’s a brand new fucking building why is it being built like there’s not a respiratory pandemic? That’s insane and bad future proofing.
posted by Bottlecap at 12:44 PM on September 20, 2022 [39 favorites]


There is no fucking way we can just dismiss hundreds of thousands of Americans dying as just politics, just like there's no fucking way we can just 'go back to normal' after all we've been through.

That's the reason there are still covid scolds. Because it's been almost three years and virtually nothing has changed and no one has been held accountable. Worse, we're just one election away from things getting much, much worse.

You don't get to hang up your mask and just say the pandemic is over any more than you get to say the recent Supreme Court decision doesn't affect you because you live in a blue state. It's not that we want to everyone to keep living like it's March 2020 but rather prevent people from going back to living like it's October 2016.
posted by RonButNotStupid at 12:48 PM on September 20, 2022 [12 favorites]


There is no lack of well-interpreted comprehensive data on the short- and long-term hazards of covid-19.

To bemoan the lack of it is to deny it.
posted by Dashy at 12:48 PM on September 20, 2022 [6 favorites]


Also I have the nerve to think that we should join civilized society and have sick leave for everyone so people don’t come into work sick. This is a humane thing that should be the case absent the current situation, but would make a significant difference in safety for everyone.
posted by Bottlecap at 12:49 PM on September 20, 2022 [13 favorites]


Anecdata: I got my Omicron booster last week, along with my wife. The local CVS had it. I got an email note from my doctor's office a few days later stating that while they thought they'd be able to give out bivalent shots, supplies are limited enough that they did not receive any yet, so "stand by and if you can get it elsewhere, do it."

But I had to dig up some of the relevant information (that it's only a two-month requirement from your last booster for this one, not six; that the age requirements are far lower for this booster; that it was available in local pharmacies right now) on my own. I can't say that my government or my media sources put a lot of effort into getting the word out that, hey, there's a shot out now that many people qualify for that could potentially save millions of Americans a lot of grief in the coming months.

I'm headed to the beach with my wife tomorrow, for a day trip. Not because it's magically safe to do so now, but more to see if it's even still there as anything resembling what it was, since we haven't been there since three summers ago. I expect that we'll be two of a small minority walking around with masks on in the shops, on the crowded sidewalks, etc. We may eat lunch and dinner in our car.

We are protecting ourselves as best we can in part for self-defense, and in part because we're traveling upstate soon afterwards to my in-laws' place, and those two have basically given up even the notion of protecting themselves against COVID. They've both gotten it in the last four months, they've both absolutely hated it, but it's just... a thing that happens to them now.

There are many people whom you just can't help past a certain point. But at least I can try not to harm via my own negligence.
posted by delfin at 12:51 PM on September 20, 2022 [2 favorites]


I loved this Twitter thread from Mia Mingus about Biden's lil announcement. It's been making the rounds of my friends today.

I am saying all of this to the folks who are reading this who are not disabled, immunocompromised and/or high risk. Do not place that burden on us. Be an ally, an accomplice. Use your power + privilege for good. You may not know it, but you have an enormous amount of influence. - from thread
posted by Kitteh at 12:54 PM on September 20, 2022 [6 favorites]


Also, I'll cut right to the chase. The pandemic isn't over until Trump and the Republicans are held accountable for everything they did, full stop. And as long as Republicans are anywhere near gaining power, we're still in the emergency phase of the pandemic.

Biden and the republicans can’t really be said to be any better, honestly. In fact I’d say they are worse.
posted by Artw at 12:58 PM on September 20, 2022 [2 favorites]


Please don't say that they're worse. If you're going to take issue with the way Biden has handled some particular aspect of the pandemic, please elaborate, but don't just make a blanket statement that he's done a worse job because that just isn't true.
posted by RonButNotStupid at 1:10 PM on September 20, 2022 [9 favorites]


There’s zero public messaging outside of attempts to everyone unmasked and back to work as soon as possible, the CDC has been thoroughly co-opted and is completely untrustworthy, and support for public health efforts is being closed down across the bars. It’s a litany of failure.

I’d give them credit for having more up front faith in the vaccine except when it turned out the vaccine wouldn’t be the end of it they ignored that and stubbornly stuck to their guns, strengthening the hand of antivaxxers.

All so Nate Silver doesn’t get a waiter with a mask.
posted by Artw at 1:23 PM on September 20, 2022 [13 favorites]


People here want us to live like it's a permanent March 2020 and well, that was never, ever going to happen. Then, we had a novel respiratory disease with no vaccine, no pharmacological treatment, no mask supply, and no established course of medical intervention. We now have all of these things.


1) covid is not a respiratory disease, it is a vascular disease (strokes and blood clots are not typical sequelae for respiratory diseases).

2) vaccines lose effectiveness as new variants evolve; omicron-specific boosters have only been available for about a week.

3) "no mask supply" is kind of irrelevant when most people seem to not care anymore (because taking precautions against a potentially disabling disease is too onerous, apparently?)
posted by Pseudonymous Cognomen at 1:42 PM on September 20, 2022 [11 favorites]


> There are currently 60 million people in lockdown in China. 60 million! Two years into the pandemic!

Out of a total population of 1,412 Million, that's about 4.2%. As a percentage of the year, that's about two weeks.

I would happily lock down for about two weeks out of the year, in exchange for dramatically less risk of death or disability. FWIW.
posted by vibratory manner of working at 1:42 PM on September 20, 2022 [11 favorites]


I would encourage you to read more about China's lockdowns because much of what I've seen is nightmarish, even if the goal is zero covid.
posted by tiny frying pan at 1:44 PM on September 20, 2022 [17 favorites]


I've read a moderate amount. There's been a range of how it's been handled - some real nightmares like Shanghai was not that long ago, and some other areas that have been pretty reasonable and successful at it. As I understand it, the implementation of lockdowns is handled by the local, not centralized government, so it hasn't been just one thing.
posted by vibratory manner of working at 1:56 PM on September 20, 2022


I was trying to hint to be cautious about appearing glib about 60 million pepple forced into lockdown in a country not our own (if indeed you do not live there currently).
posted by tiny frying pan at 1:59 PM on September 20, 2022 [8 favorites]


it's been almost three years and virtually nothing has changed

One pretty big change since March 2020: "About 95% of Americans ages 16 and older have coronavirus antibodies, according to CDC data from testing blood donor samples."

and no one has been held accountable

I mean, unless you buy into one of the many conspiracy theories about Chinese or American bioweapons, it's not really anyone's fault. Bad things happen sometimes just because nature does not care about us.

I think we should have kept more restrictions in place prior to the vaccine roll out. But once vaccines became available they were always going to be our main tool for fighting the disease. "We can go back to normal once we all get vaccinated" was the hope we all held onto, and the vaccines have delivered. I give Biden partial credit for that. (And I grudgingly give Trump a tiny bit of credit for it too. His voters hated him for it, but he did help fund and push for a very fast vaccine development.)

Estimates of the infection fatality rate for COVID -- the percentage of infected people who die as a result of the infection --put it in the neighborhood of 0.5% to 1% depending on the average age of the national population being considered. That's from back when almost no one had any immunity.

Because now, most people have antibodies, many of them from vaccines. And vaccines lower the risk of death by a factor of 10 or so.

That drops the infection fatality rate to between 0.05% to 0.1%, which is, in fact, very similar to the infection fatality rate of the flu (0.04% according to the previous link and also this old Bloomberg article).

So - vaccines are available. 68% of the US population (and 92% of those over 65) are fully vaccinated. Almost all of the rest now have some immunity from prior infection. If you would have asked me back in 2020, I would have said when we got to this point, the pandemic would be over... I have a slight caveat to that, but I'm going to put it in a separate comment because I want to quote a paragraph or two, and this comment is already long.
posted by OnceUponATime at 2:02 PM on September 20, 2022 [14 favorites]


and no one has been held accountable

...it's not really anyone's fault. Bad things happen sometimes just because nature does not care about us.


Bad things like Trump, you mean? The lack of response is what people mean when when they say accountable. And that extends to lowering mitigation now, too.
posted by tiny frying pan at 2:06 PM on September 20, 2022 [1 favorite]


There’s zero public messaging outside of attempts to everyone unmasked and back to work as soon as possible, the CDC has been thoroughly co-opted and is completely untrustworthy, and support for public health efforts is being closed down across the bars. It’s a litany of failure.

I'm not going to argue that there haven't been problems with Biden's handling of the pandemic. But I will say that as long as nothing continues to be done about the absolute clusterfuck that was Trump's response to the pandemic, we just can't have a worthwhile conversation about Biden's shortcomings because there's just no reason to think that any criticism actually matters one way or the other.
posted by RonButNotStupid at 2:12 PM on September 20, 2022 [1 favorite]


To follow up on my comment above -- if you had asked me back in 2021 how we would know when the pandemic was over, I'd've just quoted this Atlantic article at you.
“The question is not when do we eliminate the virus in the country,” said Paul Offit, the director of the Vaccine Education Center and an expert in virology and immunology at the Children’s Hospital of Philadelphia. Rather, it’s when do we have the virus sufficiently under control? “We’ll have a much, much lower case count, hospitalization count, death count,” Offit said. “What is that number that people are comfortable with?” In his view, “the doors will open” when the country gets to fewer than 5,000 new cases a day, and fewer than 100 deaths.

That latter threshold, of 100 COVID-19 deaths a day, was repeated by other experts, following the logic that it approximates the nation’s average death toll from influenza.
We have been bumping along since April at about 500 deaths per day in the US. That's because even though your chances of dying if you get COVID are now comparable to your chances of dying if you get the flu (assuming you are among the 95% who has antibodies now), the fact is, a lot more people are still getting COVID. It's still way more transmissible than the flu.

Also, I expect that 500/day number to go up again in the winter, as vaccines wear off and people gather more indoors.

So personally, I would not have said what Biden said. But I don't blame him too much for saying it. 100/day is the arbitrary threshold I latched onto based on that article, but it always a kind of arbitrary threshold, and 500/day while 5x higher, is still a lot better than the 3000/day we were seeing at the peak. And SOME SIGNIFICANT FRACTION (definitely not all) of those deaths are among people who would have been protected by a vaccine, but turned it down.

Since 500 per day is what we've gotten even with vaccines available, I am not sure I believe, now, that 100 per day is achievable on a long term basis. We could try to re-impose lock downs and mask mandates, but I don't think people would comply with them anymore, which makes them not only ineffective, but harmful, since it would reduce the effectiveness of those measures in the NEXT pandemic (by normalizing noncompliance -- we can't really enforce those measures without authoritarian levels of surveillance and mass punishment.)
posted by OnceUponATime at 2:22 PM on September 20, 2022 [4 favorites]


I would very much like to hear more about how other parts of the world are addressing covid these days

The US isn't a monolith - here in DC I still see 10-20% of people masking indoors and more than that in certain neighborhoods.
posted by aspersioncast at 2:32 PM on September 20, 2022 [2 favorites]


I mean, unless you buy into one of the many conspiracy theories about Chinese or American bioweapons, it's not really anyone's fault. Bad things happen sometimes just because nature does not care about us.

Well, I mean, there's a reason that this didn't happen with SARS-1--and it's not just that SARS-1 had lower initial transmission rates, because the initial strains of COVID-19 also had lower transmission rates than is currently the case. It's that public health authorities, including global watchdogs like the World Health Organization (traditionally funded heavily by the US, which contributes just under twice as much money as the next highest-donating member state to the WHO budget) and the American CDC, intervened almost immediately into the outbreak of SARS-COV-1 before it could spread away from the initial spillover event. Global coordination of support, quarantine, and infectious disease experts can and does stop these things before they can get into enough humans to evolve higher transmissibility. That's why these events have a high priority rate, and why they are fucking important to monitor.

The reason this happened in 2020 and not in 2002 is that Trump fired key people working in US infectious disease response in 2018, and those people weren't fucking replaced. Donald Trump hamstrung international infectious disease response, and when a potentially dangerous new pathogen popped up, response was too fucking slow to fix it. Additionally, Chinese infectious disease and public health response lagged incredibly badly in response to the threat, allowing viral incubation and spread through Wuhan that gave the nascent COVID virus time to evolve and improve. The (honestly, terrifying) COVID control measures that Xi has been putting through as an attempt to close the barn door well after the horses have escaped and picked up a taste for flesh don't negate the fact that Chinese governmental corruption created a space where their own public health infrastructure shat the bed and then rolled in it.

Both the USA and China dropped a critically important ball, and they did it because everyone in the highest levels of government among the wealthiest world powers lost sight of basic infrastructural global needs while they were busy jockeying for position during entirely human power games. On the US end, there should have been much stronger international sanctions for failures of public health reporting and heightened international pressure immediately upon learning that Wuhan was struggling, and high-level global interventions from the CDC and WHO should have been dispatched immediately. This has traditionally been one of the things we actually do pretty well, and it is frankly flabbergasting that Trump was allowed to dismember our infectious disease response for two years without attention being called to it. Now we are reaping the consequences.

There are plenty of people who are, in fact, at fault for the current state of the world, even though they aren't at fault for the initial zoonotic spillover event that created the COVID virus. Heads should roll.
posted by sciatrix at 2:32 PM on September 20, 2022 [40 favorites]


Trump's handling of COVID was terrible (outside of the vaccine development, which was good.) But he was also not all that relevant. In the US the shut downs and the mask mandates and so on were imposed at the state level by governors, and Trump couldn't stop it, much as he railed against it.

In the end the death rates in the US look almost exactly like the death rates in the EU, which had very different leadership.

So yeah, Trump was awful, but his awfulness isn't really the main reason why the pandemic sucked here. The pandemic sucked for the whole world. (And yes, I know COVID has other impacts beyond death rates, but that's what I can easily find data to quantify and compare.)

I wish we could have been New Zealand or South Korea, but our underfunded state and county based public health system was probably not going to be able to achieve that even with better federal leadership, honestly. Especially since the US population turned out to be so uncooperative. I like to think Trump could have made some of his voters more willing to do their part if he had tried... but he DID try to get them to take the vaccine, and they wouldn't. So he may have just been completely impotent, for better or worse.
posted by OnceUponATime at 2:32 PM on September 20, 2022 [2 favorites]


Trump's handling of COVID was terrible (outside of the vaccine development, which was good.) But he was also not all that relevant.

I agree with this once COVID escaped the bounds of reasonable quarantine. The place where I blame both Donald Trump and his administration is the wholesale gutting of American scientific and public health agencies which took place immediately upon assuming office in a number of fields. Essentially, the man dramatically reduced competent leadership in a number of specialist fields, which chipped away crucial pieces of the infrastructure that is supposed to globally prevent this sort of thing--which you actually can do if you're very fast and you have very well-trained people on the ground surveiling the situation.
posted by sciatrix at 2:37 PM on September 20, 2022 [19 favorites]


Yes, sorry, I didn't see your previous comment until after I posted mine. I agree there was a moment when it could have been stopped, and Trump bears part of the blame for the fact that it wasn't. So does Xi Jinping. And previous administrations in the US in other countries who didn't take pandemic preparedness seriously, and never set up the public health infrastructure we would need to respond effectively. But by about March 15, 2020 I kinda think the cake was baked.
posted by OnceUponATime at 2:39 PM on September 20, 2022 [3 favorites]


so if we could time travel far enough to remove the conditions that led to Trump getting elected, then Biden's speech about the pandemic days ago might be more palatable?

that is the tenor of quite a few comments here.. which is fine, it's fine to say "I hate that this is how things are"

I guess I'm stuck on how reproductive rights are vanishing and I'm seeing the bumper stickers north of the border "I VOTE PRO-LIFE" and the worsening water scarcity issues in southern Alberta due to climate catastrophe etc etc etc and COVID-19 is just not in the race anymore.
posted by elkevelvet at 2:45 PM on September 20, 2022 [1 favorite]


(My college roommate went on to work for first the CDC and then went on to a PhD BSL-4 disease control. Hemorrhagic fevers and response work have always been her jam, and I have never forgotten how cavalier Republicans in Congress have been about funding federal workers like her in the first decade after we graduated. After all, she was one of the people legally prohibited from working during the sequesters. Increasing Republican degradation of the US federal infrastructure creates

But by about March 15, 2020 I kinda think the cake was baked.

Oh, we are in complete agreement there. The kind of intervention I was describing should have been mobilized and actively working by January 2020; that is normally how this sort of thing works. We have a ton of case studies of similar events, and unless you're interested in them, most people have never heard of them--Four Corners hantavirus and Nipah virus and Hendra and, ha, the 2003 monkeypox outbreak, which used to be one of thoses diseases I could bring up that made people go "no way that's real!"

I just don't think there is a statue of limitations on that kind of bureaucratic malpractice, and I think that holding the decisionmakers accountable is crucial if we ever want to be able to keep this from happening again. It didn't happen with Reagan, and that was a mistake. As with Nixon, previous precedents are not good for this, and I think that's a tactical mistake: there has to be consequences for political office-holders if we're going to even pretend that the rule of law applies to everyone, and those consequences have to be harsh enough to make current office-holders blanch and consider their options. They have to have teeth.

So: heads should roll. Add this to the tally of reasons to demand satisfaction for the way in which our federal institutions have been hamstrung.
posted by sciatrix at 2:47 PM on September 20, 2022 [14 favorites]


Sorry, I'm derailing. In terms of what individual people do now: fuck if I have any good options. I'm still holding out as much as I can, but I'm also keenly aware of the cost that individual people bear if they continue to demand the most effective COVID precautions--social distancing, cessation of travel, and ventilation improvements. I don't know how to increase collective willingness to dedicate resources to ventilation, and the career costs of refusing to travel or engage in any in-person events are not something I think I can pay indefinitely either. So I mask up, I do my best where I can, and I.... honestly, don't give a shit what individual people prioritize, because there is a lot of crap going on right now and we're all trying to stumble along as best we can.

Do I kind of want to murder the people in my workplace who are currently sick with COVID for the third goddamn time? Sure! Do I think telling them to change their behavior in the absence of providing systemic incentives for people to behave in certain ways on a large scale is going to have any meaningful effect on COVID spread? Nah. I genuinely don't. There's too much collective pressure to "return to normal," and where I can, I'm focusing on battles I think are potentially winnable (like increasing WFH opportunities despite managerial yearning for control over workers) rather than, like, individual decisions.

This is a collective problem, and we are collectively deciding to do some dipshit things. I'm doing my best to minimize harm and risk given the collective situation as much as I can--given the costs of doing so--and I generally try to assume other people are, too. It sucks! It all really sucks. Right now, the biggest magnitude of risk is focused on disabling events, and that's the risk I am personally trying to manage by a) not catching COVID if at all possible and b) when I inevitably do succumb, forcibly trying to cling to absolute rest until recovery seems clear, which seems to help with sequelae of infection.
posted by sciatrix at 2:56 PM on September 20, 2022 [13 favorites]


*Increasing Republican degradation of the US federal infrastructure creates lots of possibility for catastrophe to happen, and I'm never really going to forget or forgive that.)

teach me to forget to finish my own sentences. ugh.
posted by sciatrix at 2:57 PM on September 20, 2022 [3 favorites]


I guess I'm stuck on how reproductive rights are vanishing and I'm seeing the bumper stickers north of the border "I VOTE PRO-LIFE" and the worsening water scarcity issues in southern Alberta due to climate catastrophe etc etc etc and COVID-19 is just not in the race anymore.

it's still so crazy to me how many people are 100% fine with saying "i don't care about disabled people, there are much more important things to worry about". i should be used to it by now but man.
posted by poffin boffin at 2:58 PM on September 20, 2022 [30 favorites]


I happen to think they're correct, but correct has never won elections. Biden knows that Republicans will be quick to exploit any potential weakness, and as much as I hate it, I think he's playing the game to win here, and I think that's what he has to do.

"correct has never won elections" is why we are in several messes right now.

But there is absolutely no position Biden could take which would Republicans wouldn't declare to be a weakness and then exploit it. How many times did Obama "reach across the aisle" only to get his hand bitten?
posted by Foosnark at 2:58 PM on September 20, 2022 [5 favorites]


> sciatrix: "Both the USA and China dropped a critically important ball, and they did it because everyone in the highest levels of government among the wealthiest world powers lost sight of basic infrastructural global needs while they were busy jockeying for position during entirely human power games."

For me, one of the big mysteries is the early reaction to Covid in the EU, say, right around the time of the initial Lombardy surge in mid-to-late March 2020. I was mainly paying attention to the US response so I don't have a lot of specific info about what was going on but I couldn't help but feel that some of the EU response was also kind of... slow? relaxed? Not sure what the exact vibe was but it really didn't feel like most of the EU countries were going for, say, a New Zealand style response.
posted by mhum at 3:02 PM on September 20, 2022 [1 favorite]


I just keep thinking about my grandmother on my father's side. My dad was born in 1917 (I was a late life child) and his mother died when he was 6 of influenza. When I was a kid, I thought she died in the 1918 pandemic. Then I got older and found out more about how the flu works now and assumed it was just that she caught influenza and died. But now that I've lived through this pandemic and seen people resist masking measures and seen all the historical information about how people did the same thing in the 1918 era? She died of the pandemic but they had declared it over.

I get why Biden made that decision politically, and I get that as an autoimmune patient who's in and out of immune suppressant drugs, I've got to be more conservative about my health than most people, but I also resent the hell out of the lost opportunities, especially for infrastructure (ventilation) improvements.
posted by gentlyepigrams at 3:13 PM on September 20, 2022 [9 favorites]


If I had to guess, I would guess that a bunch of EU nations were waiting to take the CDC and WHO's lead and weren't prepared for those organizations to be asleep at the wheel. I can't emphasize enough how much the US is generally swinging its international dick around on this topic. Obviously now it's clear that this was a bad idea but even under Bush no one was short sighted enough to fuck with the Ebola response people, so ... people get into habits.

Regarding Biden, I am too tired and cynical and angry to give a shit what he says. It's not enough to fix where we've found ourselves, I have no faith in the institution of the Presidency to solve anything, and as a happy bonus the American people are currently listening to it as a trustworthy source of guidance less than at perhaps any other time in US history. Fuck it.

Yeah, it's bullshit. I'm just too tired to do much else beyond agreeing that it's bullshit.
posted by sciatrix at 3:21 PM on September 20, 2022 [8 favorites]


I have enough energy to scream forever. It's the only thing I have energy for after I'm done keeping me & mine alive. But I can keep doing this forever, and I plan to.
posted by bleep at 3:29 PM on September 20, 2022 [2 favorites]


At this point I'm mildly angry, mostly depressed, and edging towards the white flag of surrender...excuse me, I mean acceptance. What good does it do for me to be angry any more. Nobody's going to listen to me, nobody's going to listen to people smarter/more in power/whatever either. People are gonna do what they are gonna do and FUCK YOU. Wear your mask, get your shots, cross your fingers, that's all you got.
posted by jenfullmoon at 3:37 PM on September 20, 2022 [3 favorites]


Mod note: a few deleted. Let’s be mindful of what our comments contribute to this thread, please consider if you are further detailing the discussion
posted by travelingthyme (staff) at 4:48 PM on September 20, 2022


Current state datapoint here:

I get about 1-2 reports a week of people calling in "tested positive", out of around 350. Not everyone tests, not everyone reports. When someone does, we seem to have gone from "presumption of close contact, prove otherwise" for co-workers to the opposite. We only ask people to stay home if it's undeniable that they were within 6 feet of the positive person, for more than 10 minutes, unmasked, AND they're un-vaccinated. Otherwise we ask them to wear a mask indoors for 5 days, honor system.

Few, but some, people still wear a mask routinely. I wear one around my neck but I only actually wear it on my face when I'm in a group of people like a conference table or in the elevator. One on one, hardly ever unless the other person is, then I match so it's not awkward. There are still some "required" places like the medical clinic.

Definition of endemic notwithstanding, it seems like it has become a fact of life that everyone accepts the risk of, like driving a car. Right or wrong, that's how it is (I'm describing, not judging). The good news is, people that do wear masks or turn down invitations to gatherings or meetings aren't shamed. That's also a given fact of life and if you want everyone there, figure out a way to do it virtually.
posted by ctmf at 5:25 PM on September 20, 2022 [3 favorites]


The good news is, people that do wear masks or turn down invitations to gatherings or meetings aren't shamed. That's also a given fact of life and if you want everyone there, figure out a way to do it virtually.

My life would feel less... well, ruined, frankly, if these two things were universal truths.

People are very willing to demand that I care for them professionally as a nurse but are very unwilling to care for or about me as an immunocompromised person.
posted by jesourie at 5:56 PM on September 20, 2022 [21 favorites]


I get why Biden made that decision politically

He really didn't "make the decision," though. He blurted out a politically stupid gaffe - something he's been known for throughout his career, it should be recalled - which took his own health advisors by surprise and makes his immediate political future much more difficult.

Unlike his many previous bumbling gaffes, this one will start killing people fairly quickly.
posted by mediareport at 6:16 PM on September 20, 2022 [9 favorites]


Covid funding was already massively slashed in the budget passed in April. Vaccines, treatments, and tests may not be covered in the incoming year by the federal government. Those free home tests are already gone.

I don't feel that this statement from Biden is a policy statement. The big decisions have already been made. It's more of an acknowledgement that he's lost the battle (a while ago), and unless something significant changes, he's not going to continue to fight and lose.
posted by meowzilla at 6:54 PM on September 20, 2022 [5 favorites]


Those free home tests are already gone.

I think it was a stop-gap. Anyone with any kind of insurance in the US (including free low-income insurance) can still get 8 free covid kits per month. I don't know what it's like in the rest of the country, but in California, I can just show up at any big box pharmacy and pick 'em up for free no problem.
posted by aniola at 7:19 PM on September 20, 2022 [2 favorites]


He blurted out a politically stupid gaffe - something he's been known for throughout his career, it should be recalled - which took his own health advisors by surprise and makes his immediate political future much more difficult.

Gaffe or deliberate policy statement isn't really the point for me. The reason Biden thinks that COVID is over strongly enough to say it is that, unfortunately, as others in this discussion point out, politically COVID is over. There's no money/policy/political will to treat COVID like a raging pandemic any more to the extent that there ever was. Whatever phase we've moved into, call it endemic or something on the road to endemic or annual, we're out of the pandemic for purposes of people collectively doing anything about it. I really don't like it but I recognize the reasons why Biden doesn't want to spend his political capital there.

And yeah a lot of people are going to die. I might be one of them. But the decision that my life and the lives of other chronically ill and disabled people aren't worth preserving if it slows the rolling of the economy was made a long time ago, and not by Biden, even if his choices/gaffes/etc. continue it.
posted by gentlyepigrams at 8:03 PM on September 20, 2022 [8 favorites]


Not sure what the exact vibe was but it really didn't feel like most of the EU countries were going for, say, a New Zealand style response.

To be honest, I think by the time that initial Lombardy surge became noticable it was almost already too late. February/March is prime skiing season and northern Italy is popular in particular with school groups. So a lot of people would have been infected and travelled home before the issue was even identified. With the added wrinkle that it would have been difficult politically to be preventing large numbers of schoolkids from going home, or trying to put them into quarantine.

The second problem is that trying to isolate a Continental European country is much more like trying to isolate a US state. Yes, they did close the borders to some extent, but you still have a lot of necessary cross-border traffic - it's often normal to live in one country and work, shop, etc in the one next door. It would have been easier in Ireland, but only if the UK had been willing to do the same, which at that point in time, it definitely wasn't.

Could they have reacted more quickly, and more strictly - yes, definitely, and there would have been a better outcome. But, it would have been considerably more difficult to do than in New Zealand, and I'm a bit sceptical that there woulld have been enough buy-in from the public. (My impression was that everyone wanted to block all the borders, *unless* it was their kid, friend, etc stuck on the other side, oh, and of course, deliveries of everything should still continue, which again mostly means cross-border journeys.)
posted by scorbet at 1:19 AM on September 21, 2022 [3 favorites]


Obligatory: Covid is not less dangerous than flu. No matter what else you think about it, I'm begging everyone reading this to consider that this reassuring tidbit isn't true.

Depressing that this disinformation is getting favourites. Since March 2022, vaccines and Omicron mean the infection fatality rate of Covid is lower than that of flu, for all age groups. Covid is 10% less deadly than flu for 80 year olds, and 90% less deadly for 20 year olds. IFR is not the only measure of danger, but it's an extremely important one.

Are some people still stuck in March 2020? Because then, yeah sure, Covid was much worse than flu. But it simply isn't true any more. Vaccines work! Omicron is milder!
posted by Klipspringer at 1:23 AM on September 21, 2022 [8 favorites]


Death is not the only risk. Less fatal is not the same thing as less dangerous.
posted by Dysk at 2:57 AM on September 21, 2022 [19 favorites]


Covid minimisers, anti vaxxers, and anti maskers have been fixated on IFR since the beginning of the pandemic because it allows you to rhetorically sidestep the much larger number of people who have been seriously hurt or disabled by covid.
posted by zymil at 3:49 AM on September 21, 2022 [10 favorites]


Fully echoing sciatrix's point here - the damage done to the international system is incalculable. From my perspective here, it was especially disappointing, because public health (not being excessively politicized by ethnofascist domestic politics) have been where we've been able to shine and be supported. sciatrix mentioned the Nipah virus -- hi, hello, from the country where that originated (Nipah is the name of the little town where the local pig farmers had the initial outbreak. A tough but valuable lesson for us - the protocols are in place that though there's another zoonotic swine flu outbreak it's been safely contained).

And you know, if COVID had a similar profile like its coronavirus siblings like SARS-1, we in this region would have had it well in hand, but official advisory was slow this time around and all the steps we had was pointless (because infectivity preceded symptomatic expressions so thermal body temp scanners at border control was ineffective). China's bad neighbour behaviour also made it worse because no one had any full viral profile that they could work on FROM NOVEMBER.

East and Southeast Asia were fully ready but we were failed by our neighbours. If not for Taiwan by way of New Zealand who is still part of WHO, we'd be even more fucked. Even parts of the Muslim world too because Middle East Respiratory Syndrome was a concern if one is to perform the Haj. And you know this included the main transit hubs used by Emirates and Qatar Airways. We could have helped to carry out a tank role in killing the spread, but I knew the die is cast when it hit N.Am and Europe, two spectacularly unprepared and (sorry to say) egotistical publics when it comes to health.
posted by cendawanita at 4:00 AM on September 21, 2022 [13 favorites]


I know it's already been explained in the thread once, but I'll explain again that a virus that is more infectious but has the same death rate per infection than the flu is going to kill more people than the flu because more people are infected. And once again there are many more consequences of COVID than just death. Even "mild" cases are leaving people with lingering symptoms for weeks to months, and that's before we talk about organ damage and Long COVID.
posted by hydropsyche at 4:01 AM on September 21, 2022 [19 favorites]


The second problem is that trying to isolate a Continental European country is much more like trying to isolate a US state. Yes, they did close the borders to some extent, but you still have a lot of necessary cross-border traffic - it's often normal to live in one country and work, shop, etc in the one next door. It would have been easier in Ireland, but only if the UK had been willing to do the same, which at that point in time, it definitely wasn't.

In Australia we did manage to close the state borders. Queensland went so far as to bulldoze earthen roadblocks. Even the NSW-Victoria border, which most people including myself believed would be impossible to close, they did it. Dozens of towns were divided in half. They tried to establish a "local zone" where people who lived in border towns or regions had passes to cross. It was brutal and disruptive and literal shanty towns emerged on both sides as people tried to cross. People were caught being smuggled in the back of trucks. This is interstate travel, to be clear. Freight never stopped, and truck drivers were often involved in cross-border superspreader events.

I am extremely thankful and grateful that eventually in Australia we got 9/10 people to get vaccinated. It has greatly reduced the deaths and hospitalisations that might have happened when restrictions were lifted. NSW is removing the last public mask mandate on Monday (requiring masks to be worn on public transport)
posted by other barry at 5:15 AM on September 21, 2022 [4 favorites]


"Covid is 10% less deadly than flu for [vaccinated] 80 year olds, and 90% less deadly for [vaccinated] 20 year olds"

Can you post a source for this information? I was not able to find it by Googling. I'd like to dig into details. Which strain of the flu? Are we comparing vaccinated COVID patients to unvaccinated (for the flu) flu patients? In what population were these measurements taken, and at what point in the pandemic?
posted by OnceUponATime at 7:13 AM on September 21, 2022 [2 favorites]


In regards to IFR, not only is the sheer number of people infected much, much larger, but now it's clear that people are rolling those dice multiple times a year.

In contrast, I think (don't know for sure) it's rare to get flu more than once every few years.

death = IFR * infectivity * repeat infections * population

And as said above, the long-term complications, both long and otherwise, are so much worse for covid than flu.
posted by Dashy at 7:52 AM on September 21, 2022 [4 favorites]


Can you post a source for this information?

Yes: Vaccines and Omicron mean Covid now less deadly than flu in England.

The conclusion has been repeated as fact by Prof Devi Sridhar, one of the leading COVID academics and someone who pushed for "zero-COVID" so is clearly on the cautious end of the spectrum: "The good news is that the fatality rate for Covid-19 – the chance of death when infected – is now below seasonal flu for the vast majority of people."
posted by Klipspringer at 8:38 AM on September 21, 2022 [8 favorites]


Thanks, that's helpful. I think their methodology is reasonable in terms of estimating the IFR for the UK population as a whole at the specific moment in time they looked at (March 2022) but it's clearly a moving target, dependent on the level of immunity in the population at a given moment and the profile of the most recent variants. So I don't expect it to be true always and forever from this point forward, for any given population or any individual person... But yeah, vaccines work, and that link is a good resource.
posted by OnceUponATime at 8:49 AM on September 21, 2022 [2 favorites]


"in England" are important words there. As far as I can tell, the vaccination rate in England is around 90%? In the US as a whole, we still haven't surpassed 70%, and in states like mine (the ones whose public health policy is focused on pleasing Trump, not protecting people), we're still below 60%.

Yes, the CDC is here in Georgia. Yes, the CDC employees whose jobs allow are still mostly working remotely. Yes, that includes CDC Director Walensky, who never moved here and still lives in Massachusetts, so what does she care how bad things are in Georgia.
posted by hydropsyche at 8:55 AM on September 21, 2022 [5 favorites]


The thing about "misinformation" is that it's false information that gives people a inaccurate information about the world which causes them to make decisions without having all the information needed. Even if you want to quibble about what "more dangerous" means if you think I'm overstating how dangerous Covid is, the worst that can happen to someone who listens to my advice is they don't get Covid or the flu & they can keep working to support themselves another day. I think that's more important than quibbling about what risks you think other people are required to take so YOU can do whatever you want.

Imagining Covid is like the flu is cutting thousands of lives short
posted by bleep at 10:14 AM on September 21, 2022 [7 favorites]


My goal in participating in these conversations is to hopefully convince even one person not to get or spread this disease. If I didn't think that was possible I'd have no interest in any of this. People who do think the pandemic is over & the risk is okay with them, I don't know what the goal is there, you've already won. You got your way. What is there to argue about now? That the rest of us also have to like it too? Why?
posted by bleep at 11:01 AM on September 21, 2022 [7 favorites]


Also, the flu is actually really bad and kills a lot of people! Flu also increases the risk of all kinds of bad outcomes like heart attacks and strokes for many months after infection and causes a lot of suffering and lost productivity.

We should be taking more measures to reduce the incidence of flu, including better ventilation, testing and surveillance, supports for people to stay home when sick, far more vaccination, and encouraging mask use in high risk settings and high risk periods.

Even if Covid was similar in impact to the flu (which it isn't, because far more people get infected with Covid than flu per year and Long Covid is significantly more common that long flu), that wouldn't be something to celebrate or reason to claim we don't need to do anything more. We should be doing more for both Covid and flu!
posted by ssg at 11:06 AM on September 21, 2022 [11 favorites]


What is there to argue about now? That the rest of us also have to like it too? Why?

I think it's the ol' "people wearing a mask reminds me that this isn't over and I hate that and want to eliminate it" thing. Also that they don't want to accommodate people who, I dunno, want to eat outside or not go out in crowds or would rather have that meeting on Zoom.
posted by jenfullmoon at 11:35 AM on September 21, 2022 [5 favorites]


What is there to argue about now? That the rest of us also have to like it too? Why?

Because we're now "covid scolds," and just like "woke scolds," trans people, and anti-fascists, we are being set up by liberals and centrists as patsies if the Democrats fail to do anything other than win decisively come this November. You can already the strategy forming in opeds in places like the NYT and Washington Post as well as Twitter and Substack.
posted by Glegrinof the Pig-Man at 11:42 AM on September 21, 2022 [12 favorites]


Like, one of the first things the Biden admin did after Dobbs hit was to complain about pro-choice activists while simultaneously preparing to nominate an anti-choice judge to a lifetime appointment.
posted by Glegrinof the Pig-Man at 11:48 AM on September 21, 2022 [4 favorites]


As someone who has multiple conditions that make it more likely that I’ll be hospitalized or die from covid, it’s like just so amazing and fabulous and makes me feel warm and fuzzy that everyone from the director of the CDC to Biden to some random professor thinks I’m acceptable cannon fodder for the economy. My life has value. So sad you’ll have to die so the rest of us don’t have to wear a mask is not the slam dunk people seem to think it is.
posted by Bottlecap at 11:55 AM on September 21, 2022 [10 favorites]


What is there to argue about now? That the rest of us also have to like it too? Why?

You don't have to like it, but I think there is value in accepting the reality of a situation, because constantly wishing the world were not so is not exactly conducive to one's mental health. I know, I'm a socialist that lives in the United States.

And to be frank, if I showed this thread to pretty much anyone in my life (all progressive liberal lefty types) they would shake their head in amazement.

If anyone judges anyone else for being more Covid-cautious than themselves, well, that's a separate issue. I have friends that don't want to eat in restaurants or whatever. That's fine by me, we can take a nice walk outside or go sit in a park or w/e.

Finally, this comment is turning into a grab-bag of semi-unrelated thoughts, but honestly, we should be talking a lot more about a massive public investment in ventilation improvements across the board. What is happening now is akin to imagining that in the mid-to-late-1800s, once the origin of water-born diseases like cholera were discovered, governments just went "well, geez, idk, boil your water I guess? Good luck man." No, what they did was build modern sewer/sanitation systems that eliminated water-born illnesses, because as a society we agreed that the acceptable level of cholera was zero.

We could do that for respiratory diseases! But we're not going to. That's what I find maddening.
posted by rhymedirective at 11:55 AM on September 21, 2022 [14 favorites]




Personally I am in this thread hoping for a better understanding of what it will mean for the pandemic to "end" and how we should evaluate the ongoing risk of COVID compared with, eg, the risks of further educational delays for kids or isolation for seniors. I don't consider the answers obvious at all, and I like seeing possible answers debated by smart people.

What do we do if we end up with some "endemic" steady state which involves 500 deaths per day forever? Surely we can't keep our kids out of school forever or keep nursing home residents cut off from their families forever? But if kids are in schools and their parents are visiting family in nursing homes, does it really matter if more corporate meetings are being held over Zoom or people are masking on airplanes? Isn't the virus is going to continue finding vulnerable people, at this point, unless we go back to full on April 2020 shut downs (assuming for the sake of argument that people would actually cooperate with that kind of shut down order now)?

Ventilation is good (though a little bit in conflict with climate change goals, since it's necessarily going to involve spending more energy on heating and air conditioning). Restoring funding for free vaccines and testing and outreach about both would be good. Requiring masks everywhere would be fine with me if I thought people would comply (though that also has an environmental impact because N95 masks are not re-usable or recyclable.)

I'm not so much on board with the idea of keeping restaurants closed or schools closed or limiting travel -- but assume we put all those policies in place -- would we keep them in place forever? If not, when do we drop them? What's the criterion?

And what do we do if 500/day turns out NOT to be a steady state? If there's a big, deadly spike again this winter, perhaps driven by a new vaccine-resistant variant? Will people tolerate the re-imposition of shut downs, or will they just ignore such orders? Are they more likely to comply in winter if we let up in the summer? How should we punish people who host gatherings and pop-up markets in private homes or "home school" their kids in "pods" of 100 or more people... What should we do to people who refuse to wear masks in public? What about people who refuse to get vaccinated?

These are sincere questions to which I really don't have preferred answers. I am in this thread hoping to read other people's proposed answers and evaluate the evidence they cite and see the counterpoints made in response, because I really do want to understand where we go from here.
posted by OnceUponATime at 12:14 PM on September 21, 2022 [7 favorites]


You don't have to like it, but I think there is value in accepting the reality of a situation, because constantly wishing the world were not so is not exactly conducive to one's mental health.

Except stating what's actually happening- a lot of people are still dying & becoming too sick to support themselves, and then people like me who can't just go wherever I want or do whatever I want ever again - IS accepting reality. Deciding that everything is fine when it isn't might be good for some kind of mental health but it doesn't work for me. And btw my mental health is just fine.
posted by bleep at 12:39 PM on September 21, 2022 [7 favorites]


The state of things is still bad even though the smiling old man said it's fine. That's reality.
posted by bleep at 12:41 PM on September 21, 2022 [3 favorites]


I came to the thread hoping there was something I could do, as in maybe someone knows about legislation or NGO efforts in the US or elsewhere that I could support to, like, improve building codes with better ventilation or something? But I don't even know where to start to go with that.

It's depressing to realize I'm expendable because I'm chronically ill and that my life/quality of life are meaningless individually, and that a lot of my ill and disabled friends are in the same boat. I'd be happy to get on the horn with with my legislators and advocate and get behind candidates because that will give me something to do rather than stew on it, or on the fact that people who are fully abled and making those decisions are one bad die roll with COVID away from being expendable themselves and ignoring it.

On the upside, I am beginning to understand the mindset of the Roaring Twenties a little better, I guess.
posted by gentlyepigrams at 12:43 PM on September 21, 2022 [5 favorites]


Just in time for fall, there’s a brand-new COVID variant making headway in the U.S.
While nothing is known about the severity of disease BF.7 might cause, so far all Omicron subvariants have had similar severity, he added. It’s unknown how effective the new bivalent Omicron vaccines will be against it.

The new subvariant has a change in the spike protein—a feature that allows it to enter cells—seen in other Omicron strains making headway. It also has a change in the nucleotide sequence—sometimes referred to as the blueprint of an organism—that could cause it to behave differently than other subvariants. But the extent to which it will diverge, if it does at all, is currently unknown, Ray said.

COVID is continually evolving to become more immune evasive, according to Ray, and Omicron is spawning exponentially. He added he wouldn’t be surprised to see a new variant altogether this fall.

“It’s been a while since we went from Alpha to Beta to Gamma to Delta, then to Omicron,” he said. “We may be complacent. This may be feeding into the notion that this is behind us.”

The tangle of Omicron spawns—with or without a new parent variant—could make for a rough fall and winter, Ray said.

His advice? Continue to mask and get your booster. And remember that the pandemic isn’t over.

“There are people who predicted COVID would be over by Easter of last year,” he said.
posted by Glegrinof the Pig-Man at 12:44 PM on September 21, 2022 [8 favorites]


Ventilation is good (though a little bit in conflict with climate change goals, since it's necessarily going to involve spending more energy on heating and air conditioning).

Or a change in perspective. I've lived a lot of mild weather places where structures are built like it's winter year-round, where code requires structures to be built that way. I'd like to see a lot more tolerance for outdoor life.
posted by aniola at 12:51 PM on September 21, 2022 [3 favorites]


proper, modern ventilation can actually lead to less spending on heating and AC - more precise control over what air is going where can give you more precise control over what heat energy is going where. This is one of the main techniques involved in achieving Passive House efficiency ratings.
posted by vibratory manner of working at 12:56 PM on September 21, 2022 [5 favorites]


Which is to say that a good system uses the outgoing air to heat/cool the incoming air via a heat pump - very efficient
posted by vibratory manner of working at 12:59 PM on September 21, 2022 [1 favorite]


We just had a discussion about the superiority of double hung windows not too long ago on the Blue: Sash windows can be a very effective source of ventilation

At least a lot of the modern buildings I've seen are sealed glass boxes with no accounting for shade/ventilation, because it is assumed that A/C will fix all the problems.
posted by meowzilla at 1:54 PM on September 21, 2022 [3 favorites]


I cannot get an online link to work to cite this, but my work gives me free NYT access and this quote is off the "California Today" newsletter.

Wachter said he had witnessed plenty of vaccine fatigue over the last two years. The constantly shifting vaccine mandates, mask guidelines and evolving virus may have caused many people to throw up their hands, he said.
“I can completely get a person saying: ‘You know what, this is too hard. I would just rather get back to normal and let the chips fall where they fall,’” he said, adding that it was still worth getting the newest round of boosters, especially to protect against the risk of long Covid."


I'm kind of baffled at how getting shots and wearing a mask is "too hard" at this point...yeah, everything changing on 5 days/10 days/quarantine/whatever is annoying, but at this point get vaxxed and wear a mask is a lot easier to figure out.
posted by jenfullmoon at 2:01 PM on September 21, 2022 [10 favorites]


That guy has been manufacturing consent since day 1. Oh I'm hearing it's too hard for other people. Not me of course. But OTHER, unidentifiable people who I can't cite. And that's fine. I'm an authority figure so I'm probably right.

Which leads people basing their entire strategy on bad faith heresay.
posted by bleep at 2:25 PM on September 21, 2022 [5 favorites]


What do we do if we end up with some "endemic" steady state which involves 500 deaths per day forever? [...] Isn't the virus is going to continue finding vulnerable people, at this point, unless we go back to full on April 2020 shut downs (assuming for the sake of argument that people would actually cooperate with that kind of shut down order now)?

I don't think anyone, outside of China, is suggesting any kind of lockdown. You might not mean it this way, but a lot of people use this line of argument (we can't have 2020-style lockdowns, so we can't have any measures to reduce infections at all) in a bad faith way, so if you're looking for a smart discussion, you might want to consider the framing.

That said, what's relevant here is how many people get infected per year, not how many people get infected overall. In countries like the US or the UK, nearly everyone has already been infected, so the question is not will people be infected or not, it's how frequently will they be re-infected — and also what are the risks of re-infection in terms of death, other severe outcomes and Long Covid. It's very clear that re-infections are going to happen over and over unless we do something about it. We can't just go back to 2019, we can't just go back to normal. Normal is gone. We can decide how we deal with the new reality, but there is no magic wand that makes everything go back to the way it was (unless a new vaccine discovery comes out of left field).

We absolutely can take all kinds of reasonable, not terribly limiting, measures to reduce the rate of spread (which reduces the number of people dying every day, the number of people ending up disabled, etc). We can start a major project to upgrade ventilation and filtration in buildings. We can do the best we can to make sure everyone gets vaccinated with an Omicron booster. We can improve testing and surveillance so we know when cases are climbing. We can encourage people not to go to work or school while sick. We can encourage mask use. We can try all these very reasonable steps — and more — or we can just give up and say it's impossible to do anything.

Will these measures reduce Covid deaths to zero? Absolutely not. Will they reduce death rates? Definitely. Why wouldn't we try and see where we end up? Throwing up our hands and saying we can't bother to try because we don't have a perfect, easy solution is just childish.
posted by ssg at 3:09 PM on September 21, 2022 [11 favorites]


We can start a major project to upgrade ventilation and filtration in buildings. [...] We can improve testing and surveillance so we know when cases are climbing. We can encourage people not to go to work or school while sick.

Not to mention that these are public health steps that would not only make a difference with covid, but with whatever new epidemics and pandemics are on the horizon, as well as the many notoriously unpleasant and too-often fatal viruses we've already got.

It's crazy not to do these things.
posted by trig at 4:07 PM on September 21, 2022 [11 favorites]


Wachter said he had witnessed plenty of vaccine fatigue over the last two years.

Oh Wachter, now it all makes sense: UCSF's Bob Wachter Says COVID Still a 'Real Threat' — but He's Ready to Eat Inside a Restaurant

He's no doubt describing his own "giving up" attitude regarding masks, vaccines, guidelines, etc.

On Twitter he was well known for going on long threads about how he "looks at the numbers" and makes up these thresholds for when it's safe to eat indoors, wear a mask in crowds, etc. He sounds like a reasonable academic.

Then he and his wife contract covid because they went to a conference. His wife has long covid.
posted by meowzilla at 4:29 PM on September 21, 2022 [8 favorites]



upgrade ventilation and filtration in buildings. We can do the best we can to make sure everyone gets vaccinated with an Omicron booster. We can improve testing and surveillance so we know when cases are climbing. We can encourage people not to go to work or school while sick. We can encourage mask use


This is the exact list of measures I said I supported in the comment to which you were replying. I am pretty sure Joe Biden also supports all of these measures.

I'm interested in how you would answer some of my other questions, though. If a vaccine resistant variant came through and death rates started skyrocketing again, what would we do? What carrots and sticks would we use to get compliance with whatever we would do? How would we know when it was time to end those emergency measures? Is 500/day low enough? Can we do better? At what price?
posted by OnceUponATime at 4:57 PM on September 21, 2022


The point is to reduce infections so that death rates don't skyrocket (and far fewer people are infected). If you wait until death rates have gone up significantly, it is frankly likely too late to do anything, as you're probably already on the falling side of the wave of infections already by the time that data becomes available. At that point, you might as well just carry on as you have been.

The reality is, no matter what you may believe Joe Biden supports, the US is not taking the basic steps to reduce infections. Worrying about lockdowns and emergency measures seems kind of odd when basic measures aren't even being implemented.

We can absolutely do better, at a very reasonable cost, by implementing basic measures. Focusing on emergency measures helps nothing.

This feels like the same pointless climate arguments we've all had so many times, where instead of discussing reasonable measures to make systemic changes to our energy and transportation systems, people just say "well, what do you want us to do, just stop driving entirely?"
posted by ssg at 5:29 PM on September 21, 2022 [10 favorites]


I guess I am saying I don't think any of the measures above is going to drop us below my previous benchmark of 100 deaths/day or prevent a spike from a new variant. Too much transmission happens in households and other private spaces. Let's agree that we should do the obvious stuff. What if that stuff is not enough?
posted by OnceUponATime at 5:31 PM on September 21, 2022


I think you're assuming there'd be a "bad variant is coming & we must do something" realization/willingness to react. By now? It seems like the lesson as learned by politicians is "that was a one-time thing". I'm not sure they're wrong, either.

What would we do if death rates started skyrocketing again? Lean harder on an already over-stressed healthcare system, make increasingly dire pleas for people to voluntarily engage in protective measures without any enforcement.

What carrots & sticks would we use for compliance? Compliance with what? Carrots require funding that Congress doesn't want to provide, and anything resembling a stick would be used as evidence that FEMA death camps are around the corner.

How would we know when it was time to end those emergency measures? How close to an election is it? Alternately, how many CEOs have recently lobbied that measures are bad for quarterly projections?

Is 500/day low enough? In the dystopian setting of Warhammer 40k, one of the great secrets of the Imperium of Man is that 1,000 people a day are sacrificed to keep the empire from collapsing, for even then that knowledge would be seen as too terrible to let be known. The United States won't be outdone so easily.

Can we do better? Much like every IPCC climate report notes in increasingly dire terms, there's nothing physically stopping us (though we're running out of time for even that level of 'technically possible').

At what price? A successful quelling of ongoing insurrection & threats of open civil war, without handing the keys over in a couple years because "It's time for the other side to have a turn".
posted by CrystalDave at 5:36 PM on September 21, 2022 [4 favorites]


… new diseases cross over from other animals to humans regularly enough that we have a World Health Organization in part to deal with the occurrence. Maybe it’s not going to be a new strain of COVID-19, but thinking the current pandemic, or the conditions in 2020, or in 2021, are one-time things is counterfactual.

(Which is absolutely in keeping with a lot of current political beliefs, I know. But we can aspire to be a little more accurate here.)
posted by eviemath at 5:44 PM on September 21, 2022 [1 favorite]


You're right, my apologies for the imprecision. We're definitely going to get more pandemics. It's the will to respond to future pandemics with the strength & urgency that we had in 2020 which I believe is being taken as a one-time thing. Masks are too controversial/political now. Too much money was spent. Too disruptive to labor markets. Here in Washington State we had a good ~30% of the population lamenting "King Inslee" taking too dictatorial of a hand in things, and contact tracers threatened with guns. And that's one of the states that's been most onboard with "literally doing anything".

It'll take a while for that lesson to fade away, and any potential pandemics in the meantime will flourish for it.
posted by CrystalDave at 5:58 PM on September 21, 2022 [4 favorites]


If a vaccine resistant variant came through and death rates started skyrocketing again, what would we do? Is 500/day low enough?

I am willing to bet pretty much everything I have that going back to 500 deaths/day would be met with a collective shrug and some thoughts and prayers. Now, if you went back to 3000/day and people are dying in hospital parking lots, then maybe you'd see some action. But short of that, I don't see it happening.

And I say that in full agreement that there are stupidly low-hanging fruit (like providing adequate funding to our public health system) that aren't happening and won't happen.
posted by Dip Flash at 7:45 PM on September 21, 2022 [6 favorites]


It's kinda like the whole "how many people have to die in school shootings before someone cares" thing. If you can't really stop the deaths (or at least nobody's willing to do what that would take), then people get numb and stop caring and give up.
posted by jenfullmoon at 9:28 AM on September 22, 2022 [4 favorites]


Which is why it's really important for individuals not to give up saving our own lives. No one else is going to come for us.
posted by bleep at 11:18 AM on September 22, 2022 [3 favorites]


I really think people forget this is a contagious disease that we get from each other. Or they can't concepualize how that makes it different from a mechanical breakdown like diabetes or something naturally occurring like pollen. People are choosing to bring this disease to other people and they have to decide to stop.
posted by bleep at 1:59 PM on September 22, 2022 [4 favorites]


My wife's mother noted that there's a church luncheon on Sunday and "we'd really like it if you and your husband would come."

I noted to my wife that this was a church day with increased attendance (another church is visiting, apparently negotiations and discussions about the ongoing schism of sorts in the Methodist world), and therefore the luncheon in the social hall would be an increasingly crowded indoor meal with a high number of older, maskless people who've just spent a fair amount of time in close proximity.

She frowned and told her mother that she was strongly leaning against going. "Will this other church be wearing masks?" "I don't know, but they might not even come," she was told. "But those who do show up would be that many more people eating in a poorly ventilated room, next to each other," she pointed out.

Her mother sighed, "Oh, you just got that new booster. You should be fine."

And that is what we are up against. The popular notion that once you're vaccinated, it's okay to re-engage in risky behavior because if you do get COVID from that, "you should be fine." Which is all right in the multitude of cases in which that turns out accurate... not so much if you happen to draw a short straw.
posted by delfin at 7:35 PM on September 22, 2022 [7 favorites]


COVID raises risk of long-term brain injury, large U.S. study finds
Julie Steenhuysen, Reuters, 9/22/22
Memory impairments, commonly referred to as brain fog, were the most common symptom. Compared with the control groups, people infected with COVID had a 77% higher risk of developing memory problems.

People infected with the virus also were 50% more likely to have an ischemic stroke, which is caused by blood clots, compared with the never infected group.

Those who had COVID were 80% more likely to have seizures, 43% more likely to have mental health issues, such as anxiety or depression, 35% more likely to have headaches and 42% more likely to suffer movement disorders, such as tremors, compared with the control groups.
posted by MrVisible at 9:24 PM on September 22, 2022 [9 favorites]




You don't have to like it, but I think there is value in accepting the reality of a situation, because constantly wishing the world were not so is not exactly conducive to one's mental health.

Another thing I want to add bc this comment stuck with me - because this is called learned helplessness and it's very bad for mammals. I was alerted to learned helplessness in myself by a therapist 20 years ago and ever since then I have rejected those impulses in myself to ensure I'm always on my own team and doing the best I can for my own well-being. That means always confronting the unpleasant truth & trying to untangle it. What we're doing now as a society is what the experimental subject does when they've been shocked too much, and it's dangerous and sad.
posted by bleep at 11:08 AM on September 23, 2022 [4 favorites]


One of the most interesting books I've read* in the past few years gets into another time when humans engaged with another numb tragedy that then seemed inescapable: high rates of infant and child mortality as a result of a thousand expensive causes, many (not all) mediated by infectious disease. The thing that stands out to me about it is the degree to which progress was slow, hard to predict, and full of unexpected events. While fledgling public health infrastructures were aided by fits and spurts of popular support here and there, notably during the New Deal era up into WWII, most of the progress that took place happened as a dull background grind, step by step by painstakingly small step. More than anything else that progress happened through moralist demands that highlighted inconsistencies in stated values and the values implied by our actions, and every major battle of that war had fierce opposition.

And then a few years would pass, and it was as if the victories won so dearly had always been here. The work to win them was forgotten so quickly. So too have other battles over dedicating resources to public health, accessibility, and safety, like OSHA or the ADA. We forget so quickly why we do boring, annoying things that we don't NEED, and the benefits of public intervention get taken for granted while the short sighted ruminate endlessly on the costs.

The thing is, we get these kinds of changes to happen societally through stories--especially stories that invoke an emotional reaction. Our collective story for a pandemic focuses around death, because in a lot of ways that's the main experience that abled folks have with the aftermaths of infection, and that's the story with the neat and tidy ending we like to tell: lots of redemptive deaths, but no one inconveniently surviving and continuing to need care. Besides, we don't have much in the way of infectious disease threats these days. Sure, there's HIV, but that just kills you one way or another. There's plenty of other disabilities that are generally sparked by mild infectious disease early in life, like HPV-induced cancers, Meniere's, ME/CF, and so forth... but those disabilities tend to onset after the initial infection is cleared and only later does long term damage reveal itself. Anything that tended towards disabling young people rather than killing them outright, like rubella, was targeted quickly by vaccination efforts. And, well.... the stories of disabled people are uncomfortable, so easy to squramishly ignore. For all that long COVID is so common, I think there are relatively few people who are open about having it and finding it disabling--although I also think that is changing and will continue to change..

I wonder how and whether those stories will start to change as COVID develops with us. This is the first plague narrative we have that has emphatically become about disability rather than survival; I wonder if speaking to more people who have been disabled by COVID will change any of the calculus.

*The book is called A Good Time to Be Born, by Perri Klaas.
posted by sciatrix at 2:24 PM on September 23, 2022 [9 favorites]


So true, sciatrix. Another example is the struggle to promote bicycle rights in Holland. That was recent, and a hard fight, driven by outrage over child deaths.

Now it's like most people believe that Holland was always bicycle friendly, it's just a cultural quirk, and fighting for those rights anywhere else is a waste of time.
posted by Zumbador at 8:37 PM on September 23, 2022 [3 favorites]


‘I’m Dropping My COVID Hubris,’ Vows a Top Immunologist; subheading:
'After the virus harmed Chris Goodnow’s heart, he joined a growing chorus against reinfection complacency.'

In a remarkably blunt interview with an Australian radio station, and later a personal column, Goodnow admitted that COVID had not behaved as widely expected.

“That is the thing that really stunned me and I’m sure has stunned most immunologists,” he said in the radio interview.

Like many scientists Goodnow assumed that any infection after vaccination would be mild; that reinfections would largely be asymptomatic; that COVID would behave like a cold after vaccination; and that variant-specific vaccines would deliver us from the pandemic.

But Goodnow now considers these assumptions wrong and has set about debunking myths that “many of us, myself included, have entertained more than we should have,” he writes. He now joins a growing cadre of scientific experts sounding new alarms about COVID, the “so many others” he says, who “are working hard to stop endless waves of reinfection.”

posted by cendawanita at 10:24 PM on September 23, 2022 [11 favorites]




To bolster vibratory m.o.w.'s point, Tüfekçi has consistently been an advocate for long covid sufferers, for instance, her recent NYT piece If You’re Suffering After Being Sick With Covid, It’s Not Just in Your Head.

I especially like that she's measured enough to stand up for people suffering ("We need a National Institute for Postviral Conditions, similar to the National Cancer Institute, to oversee and integrate research.") while also acknowledging the drawbacks of a classification system in which "a single symptom just four weeks after illness can be lumped under the long Covid umbrella with someone bedbound for years," and that "some of the [long covid] science has been truly weak".

I think this is important, because I see a significant minority of people (tremendously over-represented on the blue) who treat long covid as a sure and debilitating consequence of catching the spicy cough, even if under retirement age and well vaccinated. From this perspective it's difficult to understand the US President saying the pandemic is over. Thankfully it's not an accurate view of the world.
posted by daveliepmann at 4:08 AM on September 24, 2022 [2 favorites]


I haven't seen anyone treat long COVID as "sure". I've seen lots of people saying we can't predict who will get long COVID, and every time you get infected you're risking it. Those are both true.
posted by hydropsyche at 4:42 AM on September 24, 2022 [9 favorites]


who treat long covid as a sure and debilitating consequence of catching the spicy cough, even if under retirement age and well vaccinated.
This is pretty disrespectful to the people this actually happened to in this very thread.
posted by bleep at 8:58 AM on September 24, 2022 [7 favorites]


This isn't some rare and exotic disease. For fucks sake.
posted by bleep at 8:59 AM on September 24, 2022 [2 favorites]


Sorry if people feel like "people should try to limit the spread of diseases so they don't wreck their one and only body permanently" is over-represented on the blue but someone has to say it because it's just bog standard common sense.
posted by bleep at 9:06 AM on September 24, 2022 [3 favorites]


Here's an interesting twitter thread from Zeynep Tufekci digging into that study and talking about why the way it's being reported is not accurate.

Her problem with this study is that it looked at patients who she feels isn't representative enough of a general population to draw conclusions from. It's not that she's claiming these effects didn't happen, just that they didn't happen to anyone important enough to matter. But the people who have been hurt & killed by this virus do matter, and none of this had to happen.
posted by bleep at 9:48 AM on September 24, 2022 [1 favorite]


Nearly 225,000 Americans have died of COVID-19 since the start of 2022 despite viral declines, data shows
As the U.S. heads into the fall, wastewater levels in some parts of the country have indicated a slight upturn in the percentage of COVID-19 virus in samplings. Even so, the daily average of new infections continues to hover around 55,000 cases.

However, dozens of states have moved to shutter public testing sites, with more at-home COVID-19 tests now available. Most Americans are not reporting their results to officials, and thus, experts suggest that infection totals are likely significantly undercounted.

COVID-19 testing levels have also plummeted to their lowest point since the onset of the pandemic, with approximately 350,000 tests reported each day, compared to more than 2.5 million tests reported daily at the nation's peak in January of this year.
For the sake of comparison, the CDC estimates that, from October 1, 2021 through June 11, 2022, there have been 5,000 – 14,000 flu deaths.
posted by MrVisible at 9:56 AM on September 24, 2022 [5 favorites]


Which is still a HELL of a lot of flu deaths. I had to take someone to the ER with bad flu in 2015 and it was terrifying & excruciating. I can't imagine watching someone pass away from flu. This is serious shit.
posted by bleep at 9:58 AM on September 24, 2022 [1 favorite]


It's not that she's claiming these effects didn't happen, just that they didn't happen to anyone important enough to matter.
This does not strike me as an accurate summary of Zeynep's point, to put it mildly.

It seems to me like folks who are angry about Biden saying "the pandemic is over" also have a lot of these...extreme responses to relatively straightforward points like hers. She called (in the NYT!) for a national institute of post-viral infections, and she literally says in the linked thread that covid's effect on brain health is worth studying. I wonder why you attack her for saying we should be more judicious with scaremongering headlines like this when the study (almost entirely) predated vaccines.
posted by daveliepmann at 12:45 PM on September 24, 2022 [3 favorites]


Uh because she makes sure to include "older male VA cohort" and that this equals lack of credibility in every one of her tweets. Given that my dad & probably many others' dads are older males enrolled with the VA I don't understand how this equates with whatever point she's making about validity. What am I missing?
posted by bleep at 12:58 PM on September 24, 2022 [1 favorite]


So what if the study predated vaccines? The same disease is still around. If it was a different disease they would have given it a different name. Ok so this study doesn't particularly talk about someone my age, weight, socioeconomic background, vaccination status, and profession being effected by Covid. Okay? So what?
posted by bleep at 1:02 PM on September 24, 2022


It's not irresponsible to tell people that they studied the unvaccinated form of this disease & found xyz effects for xyz population.
posted by bleep at 1:10 PM on September 24, 2022


Look, I’m definitely in favor of continued pandemic precautions and major structural changes to deal with it. You can check my Metafilter comment history for the receipts. But the Twitter account JustSaysInMice isn’t implying that mice are unimportant when pointing out poor journalism that over-states scientific results, and Tufekci’s Twitter thread linked above is exactly equivalent. She’s critiquing bad journalism/bad science, not veterans or the need for humane COVID response policies that don’t treat some people as expendable.
posted by eviemath at 3:22 PM on September 24, 2022 [10 favorites]


On the other side, calling it “spicy cough” is dismissive and insulting, daveliepmann, and does about as much, or less, to promote good science and good science journalism as over-stating results. It is, more specifically, just kind of a generally shitty thing to say to the fellow Mefites in this thread who have had experienced more severe or long term effects from COVID for themselves or their loved ones.
posted by eviemath at 3:47 PM on September 24, 2022 [5 favorites]


Ok but her entire reason for dismissing that study is the demographics of the people studied. What is her point? Because I don't get it.
posted by bleep at 4:08 PM on September 24, 2022


But the Twitter account JustSaysInMice isn’t implying that mice are unimportant when pointing out poor journalism that over-states scientific results, and Tufekci’s Twitter thread linked above is exactly equivalent.

Saying we can't draw human conclusions from mice is the same as saying we can't draw human conclusions from... old male veterans?
posted by bleep at 4:10 PM on September 24, 2022


And to be clear I don't mean this in a "gotcha" way I mean in a "wtf" way.
posted by bleep at 4:12 PM on September 24, 2022


It’s saying that we need more data before drawing conclusions about vaccinated, younger, non-male humans from a study on a population of unvaccinated, older, male humans. Not that the outcomes for the population studied are unimportant, just that we don’t know yet the magnitude of risk increase for other populations. (Side note: universalizing adult male populations has led to quite a few problems in medicine for women and kids, historically.)
posted by eviemath at 4:49 PM on September 24, 2022 [11 favorites]


Pulmonary Dysfunction after Pediatric COVID-19
In summary, we report persistent pulmonary dysfunction as visualized on low-field MRI in both children and adolescents recovered from COVID-19 and with long COVID. The further course and outcome of the observed changes currently remains unclear. Our results warrant further surveillance of persistent pulmonary damage in pediatrics and adolescents after SARSCoV-2 infection. Given the already existing diagnostic value of lung MRI42 and the translatability of the technology, these imaging approaches can be rapidly adopted to clinical routine care.
posted by MrVisible at 4:56 PM on September 24, 2022 [2 favorites]


We need more data to say what? There are very few viruses that only affect certain demographics, and even if Covid were one of them, which it isn't, the fact that it apparently capable of damaging human brains is itself notable. It doesn't matter that much who's human brains they are. Especially when there would need to be way more vaccinated people for it to be not worth discussing unvaccinated people. There's a lot of them.

And yeah, relying on males only has junked up a lot of science. I guess I just happen to have a personal interest in what happens to that particular cohort as do I imagine a lot of people do.
posted by bleep at 5:09 PM on September 24, 2022


I am quite happy to classify myself as "stuck on Very Worried and overrepresented on Twitter," as Zeynep Tufekci put it, because we are still learning about this disease.

And by "we" I do not refer to the Ivermectin cranks or the mandate fighters or people like Rand Paul, who are simply Wrong. I refer to the fact that "not enough data" coming from either side tells me that we're still in the early stages of relevant studies, which jibes with everything that I've read on the subject. That scientists are still rooting out precisely what causes long COVID, what makes a person more or less susceptible to it, and how either the current variants or upcoming variants might alter those probabilities.

That does not mean that COVID equals automatic Long COVID or anything close to that. It does mean that even with vaccines and boosters as part of the equation, long COVID also remains part of the equation. And both Twitter and the blue are certainly overpopulated by both math people and D&D players who understand how even a low probability can be uncomfortably likely and the magnitude of being the guy who rolls the natural 1.
posted by delfin at 5:19 PM on September 24, 2022 [4 favorites]


For one thing, more data could help us determine what lowers the risk factors for covid sequelae, which is where one would begin looking for a preventive therapy or a cure. For another, having accurate risk data means that we can, theoretically at least, make better public health policy that can better meet everyone’s needs. For example, how much funding should go toward a particular line of covid research versus another option, or what level of public health investments would be needed to take care of people experiencing cognitive effects from long covid versus cardiovascular or kidney effects? And how does presentation of symptoms differ across gender, age, and vaccination status, among other factors? Eg. maybe different sub-populations will respond better to different preventive or treatment therapies? And if, as seems to be the case, regular vaccine boosters do give a significant (through not 100%) protective boost against more serious covid symptoms or sequelae, what proportion of public health efforts should go to promoting vaccination versus providing free at-home testing, or improving building ventilation, or research into non-disposable masks that could still have the same filtration as n95s? And what about environmental factors that seem to have contributed in part to the disproportionate impact of COVID on Black communities in the US? Or maybe more funding needs to go toward equalizing socioeconomic disparities that have also contributed to that disproportionate impact?

I mean, not that I expect most politicians in the US to go for any of that without much more public pressure than currently exists, but accurate science and accurate science reporting helps us build that pressure while inaccurate science or science reporting harms or derails such efforts, or leads to COVID funding being spent in useless, unhelpful ways. Plus, it matters to me that I advocate for the right things.
posted by eviemath at 6:55 PM on September 24, 2022 [6 favorites]


All of that is granted but the claim that a study should be criticized because it looks at one particular group? The criticism we're discussing?
posted by bleep at 10:38 PM on September 24, 2022


My critique of the original tweet is that folks who are scared of admitting that this disease is scary just write off all evidence as it not being scary enough for them because {list various nitpicks like doesn't see self personally represented in the data}. My point is if you want to say "Look some reasonable folks think this disease is not that scary & we're overstating it" I have yet to see a convincing argument.
posted by bleep at 10:43 PM on September 24, 2022


She wasn't criticizing the study at all! She was criticizing how the findings of the study were reported. The study said "here's what we found for this specific cohort"; the press coverage was all "study says the following about everybody".

I can't easily copy the tweets right now but she criticizes journalists for not carefully reading the actual data presented by the study and for not consulting with people who do know how to read scientific papers. She said misleading framing of scientific findings erodes trust in journalism and in science itself.

She's not saying brain damage isn't important or that unvaccinated male vets aren't important. She's saying, be accurate. Headlines that say x% of all people are affected in the same way, when in fact it's only x% of some specific cohort, are a real problem, whether they're saying that chances of brain damage are high for everyone because they're high among unvaccinated male veterans, or whether they're saying that only a small percentage of all people die of covid, because only a small percentage of all vaccinated, young people with no preexisting conditions die of covid.

She's not talking about covid being scary or not scary. (She generally falls on the side of "very scary"!) She's saying, misreporting scientific results can have scary side effects and it's not okay to do it.
posted by trig at 10:55 PM on September 24, 2022 [14 favorites]


I follow her twitter as well and in the last year+ her main concern really has been the state of (science) reporting on this disease. She's got a good point that the squishy summations aren't helping general population-level understanding especially when ppl conclude it's either too confusing or scientists don't know what they're talking about, and then complicated by the politics, which a lot of reporting don't contextualize well. And that's not getting into not having the facility to communicate how to understand preprints and small cohort studies etc.
posted by cendawanita at 11:46 PM on September 24, 2022 [5 favorites]


She's "Craig Newmark Professor of Journalism and director of the Craig Newmark Center for Journalism Ethics and Security" at Columbia, so it makes sense that this is a point of focus for her.

(Craig as in Craigslist Craig, apparently!)
posted by trig at 12:37 AM on September 25, 2022 [1 favorite]


All of that is fine and good except I stand by my critique that her main point is that people are going to get the wrong idea from seeing a study about a particular cohort and not immediately writing it off because they're not in that cohort and I strongly disagree.

People get the right idea when they hear that this is a dangerous virus & use that information to avoid it, even if the particular danger happened to someone who was unlike them.
posted by bleep at 9:42 AM on September 25, 2022


It's as if people are only capable of remembering one thing at a time - should people protect themselves? Or are we engaging in a population-level effort? And if so, does anyone need to bother?

The answer is yes, unequivocally, and we need to hold both things in our mind at the same time. People must think defensively about their own health, and they also must think offensively about the health of the entire population they live in, if a human society is going to make it. And I want to make it!
posted by bleep at 9:46 AM on September 25, 2022 [1 favorite]


The fact that so many people think they can make a logical, humane case for the complete disregard of human prosperity on display here is I guess something I would have to be neurotypical to understand.
posted by bleep at 9:50 AM on September 25, 2022


All of that is fine and good except I stand by my critique that her main point is that people are going to get the wrong idea from seeing a study about a particular cohort and not immediately writing it off because they're not in that cohort and I strongly disagree.

Her main point is that people who follow along for five minutes will see that the study is making claims that its sampled population cannot support and will write off the entire field. As a biological researcher--admittedly one who is also terrified of long COVID and acting accordingly--I agree with her analysis wholeheartedly. If people perceive you as lying to them or exaggerating, they will not listen to you when you are being as honest and measured as you can be. The ends do not justify the means, and those predictions about long COVID rates need to be framed in terms of the sample populations that were used to calculate them. Failing to do so risks trust in the same message the authors are trying to send.

Is there any hypothetical experiment in which the stated conclusion was "avoid COVID, long COVID is bad" that you would not support or defend against criticism, bleep? What would that look like for you?
posted by sciatrix at 9:54 AM on September 25, 2022 [8 favorites]


People get the right idea when they hear that this is a dangerous virus & use that information to avoid it, even if the particular danger happened to someone who was unlike them.

Following this logic out, why bother with studies at all? If all that matters is getting people the right message, just cut out the middle man of doing studies to find what you want, and just say what you want.
posted by Dysk at 10:06 AM on September 25, 2022 [2 favorites]


except I stand by my critique that her main point is that people are going to get the wrong idea from seeing a study about a particular cohort and not immediately writing it off because they're not in that cohort

This does not seem like an accurate or fair summary of the point she is making.
posted by Dip Flash at 10:37 AM on September 25, 2022 [7 favorites]


Is there any hypothetical experiment in which the stated conclusion was "avoid COVID, long COVID is bad" that you would not support or defend against criticism, bleep? What would that look like for you?

Here is an if I can speculate about:
If I wind up in a building where someone has expelled the Covid virus into the air, and if it evades my defenses and my immune system is overwhelmed, and I contract long Covid & can't support me or my husband anymore...
...... is anyone in this thread going to pay my rent? Because disability isn't going to cut it, if I even get that.

All I want is for there to be less of this shit in the air, and the only way that can happen is if people decide to stop expelling it unchecked in their aerosols.
posted by bleep at 12:29 PM on September 25, 2022 [1 favorite]


Following this logic out, why bother with studies at all? If all that matters is getting people the right message, just cut out the middle man of doing studies to find what you want, and just say what you want.

A study is a story about an investigation & what was found. You can use the same study to make different points.
A good point is: wow this group of people is suffering, how can we better support them?
A bad point is: you are not in this group, so saying they're under threat doesn't mean everyone is.
posted by bleep at 12:31 PM on September 25, 2022


And for the record, here's a list of things I would not defend from criticism:
-Did not follow an ethical protocol
-Poor study design resulted in data that can't really be math'd the way they're mathing it
-conclusions unrelated to the data shown
Etc
posted by bleep at 12:37 PM on September 25, 2022


May I gently suggest that aiming for a single comment instead of sets of three would slow the commenting process down enough to perhaps enable some reflection on whether or not your interpretations of other comments are fully accurate, or enable the opportunity to notice when others are supporting the same goals as yourself.
posted by eviemath at 1:01 PM on September 25, 2022 [10 favorites]


the study is making claims that its sampled population cannot support and will write off the entire field.

The claim is that this is a virus that damages human brains. The sampled population can indeed support that. They have human brains.
posted by bleep at 2:58 PM on September 25, 2022


I can never figure out why "we don't understand this new virus that's killed millions of people" is always followed with "so why worry about it?" instead of "so we should take all reasonable precautions."
posted by MrVisible at 3:29 PM on September 25, 2022 [6 favorites]


"Distance and complexity are the enemies of action." Consistent, clear, and accurate messaging would have gone a long way.
posted by aniola at 3:47 PM on September 25, 2022 [4 favorites]


The claim is that this is a virus that damages human brains. The sampled population can indeed support that. They have human brains.

The sampled population all have lots in common that you cannot generalise to the rest of their population. By the same logic you can make the claim that covid causes people to be a male veterans. The same study banks it up in exactly the same way.

A study is a story about an investigation & what was found.

No? A study is the investigation itself, not a story about it. And the study does not show that humans anything, you cannot generalise from a specific demographic to a much broader one. It's not because it was older been specifically, you also can't look at how it affects just going girls, or teenage non-binary people, or any specific group, and make statements about people on that basis. It's just not how it works. The fact that there is an ugly history of erasing and mistreating anyone who isn't an older usually white man, specifically because of over-generalising from older white men, well, it's not a good look.
posted by Dysk at 4:35 PM on September 25, 2022 [9 favorites]


So you think this is all about me defending white males from having not been given a fair shake? Dear god no. I apologize for whatever I said that gave that impression. That's not at all anywhere near what I'm trying to say.

I also apologize for whatever I said that has made everyone mad at me for asserting that diseases must be controlled. I have no idea why this is considered so controversial.
posted by bleep at 6:48 PM on September 25, 2022


We’re not mad at you for asserting that diseases must be controlled. We’re (most of us) not arguing against pandemic controls. We’re (speaking for myself at least) frustrated at you for continuing to misunderstand Tufekci’s Twitter thread despite multiple explanations, and for not engaging with those multiple explanations, and for imputing incorrect viewpoints to several of us in this comment thread. Your writing is coming across as rushed (pairs of comments is not a significant improvement on triplets), and you seem to be having a little bit of difficulty discerning friend from foe in this thread. It might be time to take a pause and come back to this after a mental break from the topic.
posted by eviemath at 7:36 PM on September 25, 2022 [14 favorites]


Tufekci is saying that, because Covid is incredibly dangerous and has serious long term consequences, we should communicate clearly and effectively about it.

She knows that, rightly or wrongly, the general public will take warnings about people like them more seriously than warnings about people who are different from them.

So using a study about unvaccinated older men as a a way to convince people who are young, vaccinated, etc, will likely not convince them.

And its crucial to convince them, partly to protect older people and people who are different from them.

She's saying "don't use this study when trying to convince people".

The stakes are high, and we need to communicate effectively. We can't change peoples prejudices, but we can work around them.
posted by Zumbador at 9:24 PM on September 25, 2022 [2 favorites]


Mod note: One deleted. Bleep, you've been waaaaaaaay overcommenting here, and have basically completely taken this thread over. Please leave it alone now.
posted by taz (staff) at 9:56 PM on September 25, 2022 [5 favorites]


Your writing is coming across as rushed (pairs of comments is not a significant improvement on triplets)

I don't think this needs to be a side discussion or a MetaTalk or anything but I just want this thought on the record for general welcomingness -

The quality of a comment is more important than the number of times in a row someone hits the post button.


Also I just want to cheer everyone reading this on. Keep doing the things you're doing that are in line with your best values. With the pandemic, and everything else, besides.
posted by aniola at 12:07 AM on September 26, 2022 [2 favorites]


I can never figure out why "we don't understand this new virus that's killed millions of people" is always followed with "so why worry about it?" instead of "so we should take all reasonable precautions."
I don't see a specific comment you're referring to, but one possible reason for this disconnect is that I think we largely do understand it. It's a novel coronavirus. We know coronaviruses. Its novelty makes it dangerous but we have several vaccines that make it not novel and thus not so dangerous. We have effective post-infection treatment protocols. We know it is particularly dangerous to the obese and elderly, but largely and mercifully has a low rate of severe illness in the young. We know it is like other viruses in that it sometimes causes post-viral ailments. We know it's catchy enough that even strict non-pharmaceutical interventions have little effect on rate of spread. We know it's not going away so we know essentially everyone will get it. What else is there to know for the lay public?

Another possibility is that folks who reach a different risk management conclusion than you are, in fact, taking all reasonable precautions in light of that knowledge. I'm not really talking about the unvaccinated, who are driving a disproportionate amount of the continuing death toll, though they too are entitled to their own risk assessment, now that we're arguably past the stage where non-draconian restrictions are effective. I'm talking about folks who masked and isolated and got vaccinated...and now weigh the substantial costs of indefinite masking, isolation, and disruption of society against the substantial benefits of living normally with the powerful protection of vaccines.

It might help to say it with risk equivalents over time.
  • In February 2020, I didn't know the risk but estimated it could be quite high.
  • By February 2021 it was clear that
    • without vaccines, getting infected was a moderate risk to myself but a severe threat to my community
    • with vaccines it would be a slightly greater than normal risk to myself but still an unacceptable threat to my not-yet-widely-vaccinated community.
  • By February 2022 it was common knowledge that
    • everyone who wanted to be vaccinated was
    • hospitals were no longer at risk of being overrun
    • the risks to myself with a booster were within the bounds of what I normally accept
    • this would be the ongoing status quo
I've seen nothing to change those last conclusions. I consider Biden's statement an acknowledgement of these four basic facts. I'm glad to hear it stated plainly. It's time for society to move on from the acute stage and start developing broad, long-term resiliency against viruses and pandemics. I'm particularly enthusiastic about funding basic research, robust local manufacture of medical supplies, and ventilation.
posted by daveliepmann at 1:06 AM on September 26, 2022 [4 favorites]


everyone who wanted to be vaccinated was

This is not at all true. There are many people who, for various health-related reasons, cannot have the vaccine.
posted by Dysk at 1:09 AM on September 26, 2022 [5 favorites]


You're right, I was uncharacteristically insufficiently pedantic in that instance. I empathize with those people.

If you think that undermines my broader point, perhaps you could elaborate. Your comments above seem to suggest that you would like society to restructure itself permanently (maybe only for the next several decades, but at least indefinitely) along something like to the widespread mandatory stay-at-home restrictions common in mid-2020, or like China's current zero-covid policy. Do I have that right?

(I'd like to emphasize again that anything short of such extreme measures will probably only make a marginal difference in prevalence, as explained in the two links I posted.)
posted by daveliepmann at 2:14 AM on September 26, 2022 [2 favorites]


You might be confusing me with somebody else? The vast majority of my comments in this thread have been about the definitions of pandemic and endemic, and pushing back against the idea that a study in unvaccinated older men can be generalized to the wider population. I'm certainly not sure where you get "restructure society like China for decades" from something as anodyne as "the discussion [to be had] is about balance of harms" which is my one comment that incorporates anything of my view on his the situation would be handled.

So no, you have the almost as wholly wrong as is possible.
posted by Dysk at 2:40 AM on September 26, 2022


I was uncharacteristically insufficiently pedantic in that instance

I’m not seeing the evidence for the “uncharacteristic” claim of this statement in your other contributions to the thread?

Ignoring and minimizing populations more harmed by the pandemic is every bit as obstructive for adequate, and appropriately balanced, public policy responses as over-stating study results. Pundits who have been pushing such a viewpoint are also one of the main reasons why we have to worry about being so careful about not over-stating results from studies, since they tend to also over-hype “blah blah this study was wrong” as if it was completely wrong, not just limited in the population studied. The hypocrisy in this doesn’t seem to phase them, though one might hope it would distress a Metafilter commenter.
posted by eviemath at 3:44 AM on September 26, 2022 [2 favorites]


You're right, Dysk, it seems I did misinterpret your earlier comments. Sorry! I remain curious what you consider to be "mitigations [which] are still sensible".

Eviemath...look, I know the internet is the great context-destroyer, but not every thread has to be 100% about the most harmed and vulnerable people all of the time. This is a thread about POTUS saying that we're past the NPIs of the last two and a half years. The mefi response is overwhelmingly (though not entirely) to howl in anger. So I specifically used the term "spicy cough" to try to shake covid-is-still-paralyzingly-dangerous folks into realizing that the vast majority of people who gave up their social and economic lives for over a year did so out of solidarity for others and not personal risk, because covid is, in a very real sense for those hundreds of millions of people, a spicy cough. People use this lingo to make light of a time that was harrowing for them largely not because of a virus but because of our (necessary) countermeasures. We should make space for that, and for people to say "thank goodness POTUS said this", and to express the (extremely common) view that the risks are back to normal for most of us.
posted by daveliepmann at 4:28 AM on September 26, 2022 [1 favorite]


My biggest bugbear is masking on public transport. It's a context where you are almost uniquely cooped up in close proximity with a large rotating cast of strangers, for extended periods of time, with often incredibly poor ventilation. I feel like it's not a big ask.
posted by Dysk at 4:32 AM on September 26, 2022 [9 favorites]


daveliepmann, what makes you think that the Mefites who are commenting about themselves or their loved ones being in the higher risk categories and feeling tossed aside by comments such as Biden’s aren’t (for the most part) fully aware that others either have or feel like they have lower risk from COVID? What makes you think, in general, that US public policy around the pandemic has catered more to higher risk folks rather than the opposite? Recognize that your “spicy cough” flippancy was punching down, and poorly thought out. (And there are many examples on Metafilter where we ask people not to be flippant about topics that have had major negative impacts on other members of our Metafilter community.)
posted by eviemath at 4:55 AM on September 26, 2022 [7 favorites]


I feel that you and I are talking past each other. I'm going to look up booster policies in my city. All the best.
posted by daveliepmann at 5:02 AM on September 26, 2022


the risks to myself with a booster were within the bounds of what I normally accept

I don't normally accept that walking around in daily life I could catch a communicable illness that will affect my entire life moving forward.

I've relaxed some of my standards and that scares me. Trying to mask as much as I can make myself and still incredibly nervous looking around at how few seem to care at all. And I had covid.
posted by tiny frying pan at 5:04 AM on September 26, 2022 [5 favorites]


I don't normally accept that walking around in daily life I could catch a communicable illness that will affect my entire life moving forward.
You may not have consciously accepted it, but you have certainly lived with these risks all your life. As we all have. What do you believe is unique to covid in this respect?

I know someone who suffers lifelong effects from one time they had a wild infection, similar to this mefite's comment about permanent damage stemming from strep throat. These things happen.

Separately, it's good that covid is bringing attention (and hopefully large amounts of research funding) to post-viral syndrome, but it's by far from the only cause. Over-focus on covid's role here would be an error.
posted by daveliepmann at 5:27 AM on September 26, 2022 [2 favorites]


What illnesses are you talking about? I'm curious what would be even comparable to covid - like, nothing, right? Because we would have heard about it, in some capacity? Certainly not in amount of risk. I've had strep throat several times.

The comment you link to - of course getting covid repeatedly isn't a direct one to one to getting long covid. But the risk is there with every infection.
posted by tiny frying pan at 5:34 AM on September 26, 2022 [2 favorites]


(I have never lived with a risk of a communicable disease this large potentially affecting my entire life moving forward. I feel confident saying that. I hope regarding covid, in the coming years, this will change. But we aren't there yet by a long shot.)
posted by tiny frying pan at 5:36 AM on September 26, 2022 [4 favorites]


What illnesses are you talking about?

Just offering my pov: this is actually a known consequence of a number of viruses, including the other kinds of flu and also strep throat. (ETA: i forgot to namecheck SARS-1!) A lot of post-viral exhaustion used to be not taken seriously -- a friend of mine got Lyme disease just from one visit to the US and that wiped them out.

TBH, knowing this is actually why i feel I'm more careful than maybe daveliepmann. I've never raised it here but over here, dengue fever (similar profile to west nile fever but different mosquito species) is common/endemic and at this point generational. Thankfully it's not airborne (just like my Lyme anecdote) but because of the climate it's extremely pervasive. It's also a disease where public health messaging has successfully communicated that reinfections often result in worse conditions, even death. So I feel like encountering western-centric conversations always require a little readjustment for me. There's a sense of ... Idk, Eden lost? (I did say i find western publics to be psychologically unprepared) But i don't think anyone still actively commenting in this thread would disagree on personal steps that needs taking. But ambient risk really isn't all or nothing.
posted by cendawanita at 6:14 AM on September 26, 2022 [9 favorites]


A lot of us didn't know before that there were long term postviral syndromes associated with e.g. the flu. Now we know. The conclusion many of us who are already disabled have reached isn't "oh covid is like the flu in this regard, I can be less careful like I used to be with the flu" but "oh, the flu is like covid in this regard, I can take some of the same measures, I wish I'd understood this years ago!"

If COVID vanished tomorrow part of my takeaway would still be "masking in crowded public areas is a low effort thing I can do that means I am safer from a variety of illnesses and their long term side effects." I haven't had a four month bout of bronchitis since 2019! It's amazing!
posted by Stacey at 6:30 AM on September 26, 2022 [9 favorites]


Yes, exactly. It's not Buddhism or high-consensus cultural magic juice about why it was easy enough to get ppl in my region to mask over here.
posted by cendawanita at 6:32 AM on September 26, 2022 [6 favorites]


I've never raised it here but over here, dengue fever (similar profile to west nile fever but different mosquito species) is common/endemic and at this point generational. Thankfully it's not airborne (just like my Lyme anecdote) but because of the climate it's extremely pervasive. It's also a disease where public health messaging has successfully communicated that reinfections often result in worse conditions, even death

I've also thought about dengue a lot in the context of covid. I lived in places with both active dengue outbreaks (including hemorrhagic) as well as just endemic. There are things you can do to lower your risk (like having window screens on your house, say) but you can't lower that risk to zero. You are basically taking on a higher baseline level of risk just by existing. (I've spent much less time in places with high levels of malaria, and that felt similar but I was visiting, not living there, so I don't want to generalize from that.)

That's something that the US and Europe haven't really had to deal with at a societal level since they eliminated malaria generations ago, and I can believe that it would change how people talk and think about covid.
posted by Dip Flash at 6:56 AM on September 26, 2022 [4 favorites]


I don't see a specific comment you're referring to, but one possible reason for this disconnect is that I think we largely do understand it. It's a novel coronavirus. We know coronaviruses.

Is SARS-CoV-2 an oncogenic virus?
We show convergent evidence from three different transcriptomic datasets and techniques that represent a molecular proof of concept that p53 may be acutely and persistently reduced after severe SARS-CoV-2 infection. A persistent reduction of the p53 tumor suppression functions, as might be the case in long-COVID-19 severe patients, may constitute a risk factor for oncogenesis comparable to pathogenic mutations in TP53. Such long-term reduction of p53 might trigger cancer onset or contribute to worsen the course of patients with an ongoing tumoral process (1, 2). Future efforts should target larger cohorts and follow-up time, and assess additional types of samples, including lung tissue. A causal relationship between SAR-CoV-2 and cancer has not been demonstrated but, if confirmed, it would have enormous impact on public health.
posted by MrVisible at 8:15 AM on September 26, 2022 [3 favorites]


Just offering my pov: this is actually a known consequence of a number of viruses, including the other kinds of flu and also strep throat. (ETA: i forgot to namecheck SARS-1!) A lot of post-viral exhaustion used to be not taken seriously -- a friend of mine got Lyme disease just from one visit to the US and that wiped them out.

Yep! There are also a number of other disabling post-viral syndromes out there that I would personally prefer to avoid, like Meniere's which seems to often be a consequence of mononucleosis / Epstein-Barr. (Epstein-Barr virus in general: not super contagious but quite common, and associated with quite a few unpleasant disabling conditions.) There are actually a lot of viral infections where disability is a more well known consequence than death, but we vaccinate against many of them these days for that reason. For example, we vaccinate against rubella not because rubella will kill you (it generally won't), but because when pregnant people contract rubella at a particular point in development, their babies are often born with deafness, eye abnormalities, and/or certain heart conditions. Similarly, we vaccinate against mumps not because it usually kills children (it rarely does), but because in about 4% of cases it renders people who catch mumps deaf, sometimes with vertigo or balance issues.

Sometimes we don't even know what kinds of postviral consequences given common viral contagions confer until after we eradicate them: famously, it turns out that measles infection induces post-measles immunosuppression and erases past resistance to other, totally unrelated infectious diseases, rendering infected people much more susceptible to other diseases after infection.

When we talk about the morbidity of infectious diseases in a public health context, not just the mortality of these diseases, we're often talking about the overall cost of illness and disability well over the actual death toll of diseases. This is a huge thing in infectious disease work, and the main reason it's not as heavily emphasized in the US and Western Europe is because for several decades the prevailing opinion in public health was that infectious disease was a largely solved problem in the West, one that "developing countries" had to struggle with but that wealthier nations could avoid with good infrastructure. That begun to change after HIV, and more so after the rise of anti-vaxxers and new zoonotic spillover events. It will continue to change further as climate change broadens the range of some infectious vectors and allows new infectious diseases to persist in new places.

Like it or not, the US and Europe need to do a better job of public education on this sort of thing, because infectious disease is a global problem--and climate change, along with political turmoil, is only going to make that more so. We need to listen to what has worked for public health campaigns and public messaging in countries that have been grappling with infectious diseases as a threat outside the context of HIV, which is an outlier in many ways but is also the center of most infectious disease public education in the US.
posted by sciatrix at 8:39 AM on September 26, 2022 [14 favorites]


tiny frying pan: I have a weak understanding of the science but I think there are two mechanisms for lasting effects; one is direct damage from a fever (e.g. the heart murmur in the linked comment) and the other is lingering infection after the acute immune response — that is, you never really kick the bug. From what I read, a wide variety of viruses can have these effects.

I am not convinced that covid is anything special in this regard – in fact, it occurs to me that the term "long covid" itself might be better retired, and we should all learn the standard terminology about post-infection sequelae, post-viral syndrome, and so on.

Regarding risk with each reinfection, I think you should look at this diagram. The relevant text:
Re-infections and breakthrough infections become progressively milder on average in the majority of people. That doesn't mean that a particular person may not experience more severe symptoms the second or third time, for all sorts of reasons... Symptom severity is drawn from distributions around a mean of decreasing symptom severity over successive reinfections. Vaccination also pushes the distribution to the left.
This is how we should think about Covid outcomes. Each infection is a range of possibilities, with each reinfection more likely to be milder.

Lastly, amount of risk. The CDC has some great charts: Deaths by Age Group (among others) and Cases and Deaths by Vaccination Status. My favorite is the second chart, after clicking "Age Group" above it, because it shows that deaths for "vaccinated with a booster" is basically a flat line at zero compared to the spikes of the unvaccinated. (The CDC also has a page which charts outcomes by underlying medical condition like obesity but I find it difficult to read; suffice to say that being fat and out of shape increases risk somewhat.)

But I think the useful thing to do is find equivalent risks:
Living in New York City in the height of its COVID-19 outbreak in March–June 2020 resulted in about 50 excess micromorts per day; similar to that of being a U.S. soldier in Afghanistan in 2010... What is the risk that I, personally, face as a vaccinated and relatively healthy young adult? Based on CDC data [in 2021]...0.25 micromorts per day.
Scary for the unvaccinated, not so scary for the vaccinated. I wish more people were doing rigorous work showing equivalent risks. I ran the numbers for myself in 2020 and stayed home. When I ran them again last winter it was close enough to flu that I stopped worrying, but I didn't save my work. (I'm purposefully invoking Cunningham's Law here.)
posted by daveliepmann at 9:00 AM on September 26, 2022 [2 favorites]


That diagram is a graphic of overlapping normal distributions marked by smiley face emojis and no supporting information. Why do you think that reinfection is likely to be less debilitating and carry fewer risks of long-term damage than initial infection?

To be explicit, one of the interesting dengue fever parallels from upthread is that contracting dengue fever once and then recontracting it can result in a vastly more severe experience the second time. This isn't uncommon--sometimes, immunity does weird things, and while usually having experienced a disease is protective, it's possible that it can in fact weaken the immune system such that second experiences can be worse.

Now, the general assumption that I am seeing in this thread is that reinfection carries approximately the same level of risk of developing long COVID sequelae as initial infection does, and that you are essentially rolling the same die and trying to avoid the bad outcome each time. I think that's a very reasonable approach to take to risking reinfection, given that COVID is known to follow the same pattern as dengue--that is, initial infections have a wide range of severity, contracting the disease results in a lowered risk of contracting it again, but for individuals who do re-contract it, there is a significant risk of a heightened severity of infection relative to the initial bout.
posted by sciatrix at 9:19 AM on September 26, 2022 [5 favorites]


Or rather, to clarify: where in the hell is Balloux sourcing his curves from, because I don't actually see any reason to think that reinfection curves follow a normal distribution of severity shifted neatly to the left as he is describing. The evidence I've seen suggests that you're actually looking at something more like a bimodal distribution with one larger leftward peak and a smaller rightward peak.

Of course, this is an actively developing field and the lit is still being generated.
posted by sciatrix at 9:23 AM on September 26, 2022 [2 favorites]


Balloux sometimes does rigorous stuff, but I don't think this one is intended to be :) As far as I can tell he's reminding us how we should expect a coronavirus to behave (viz). I think this is important in light of the study he refers to in this thread. (I suspect that among the forever-masking lay public the initial scaremongering reports around that study linger, the critiques were never seen, and this is why reinfection is treated like a terrifying specter instead of a path to normalcy.)

In the search for a response to your question I stumbled across this tweet of his about a study relevant to this question. Zeynep pull-quoted a striking chart from the same study, which is probably the most clickable link here. Balloux gets into some technical details in this thread about reinfection.

I'd be interested in anything medium-technical you could link to about the bimodal distribution you describe. I hadn't heard that before.
posted by daveliepmann at 9:50 AM on September 26, 2022 [2 favorites]


From what I read, a wide variety of viruses can have these effects.

Do any, in recent history, have the amount of current risk of covid? The rates of long covid are HUGE. This is different in my life compared to any other possible post viral infection. I am not extrapolating to the world, for other illnesses. I understand I am probably privileged to not have ever had to worry about this. But yes, this instance is different for me, and worth deeply worrying about.

As for every infection being expected to be milder...this virus is still mutating. There is no guarantee that it won't become nastier than we've already experienced.

Not anything special?!?!? Yeah, no, thanks.
posted by tiny frying pan at 9:55 AM on September 26, 2022 [4 favorites]


Yeah. Much like climate change, the devil is in the rate of change/risk.

But ambient risk really isn't all or nothing.

Exactly. Understanding what the risk is (neither lowballing nor highballing it) helps us make the best public policy and best use of limited resources.
posted by eviemath at 10:02 AM on September 26, 2022 [3 favorites]


Going through whatever the variant is surging right now, and even with paxlovid it’s fucking nasty. Would not like to meet a worse one.
posted by Artw at 10:10 AM on September 26, 2022 [7 favorites]


The rates of long covid are HUGE.

My sense is that it's about as nasty as SARS-1 proportionally speaking. It looks objectively more but not proportionally so (but the lit is still developing). Objective raw numbers are high because of all the factors we've gone over which resulted in more people getting COVID, period. And yeah, there is privilege of never having to think about this. But I'm truly sympathetic to the emotional state because your governments and corporations have failed you, no ifs and buts. Over here we're still active memory keepers of horrible consequences of viral infections so even when governments fail us (relaxation of rules; no available vaccines) there is general motivation to do something (masking; throwing the windows open), and it turns out we still have enough governance (civic and public) that there are systemic solutions in place so what little individual actions we take is being bolstered by the environment. We had to think about this because we never stopped thinking about it.
posted by cendawanita at 10:19 AM on September 26, 2022 [5 favorites]


You know, I'm one of those people who always gets whatever flu is going around, despite getting flu shots, and I am not young. So, I've had a lot of flu. (I also had Mono in college). In January, despite being double vaxxed and boosted and cautious, I got Covid. We have shared laundry rooms and I'm pretty much the only one masking there, and, given the timing, that is most likely where I got it. It hung on for a long time but was so mild that I almost didn't get tested. And you know, I have some aphasia now, specifically a real drop in ability to recall the names for things and people. From one "mild" bout of Covid. Randomly talking to someone at work, he shares that he has some too from his "mild" Covid case. So please don't tell me it is just like the flu, or the effects are just like the flu, or even milder than the flu, because I have had both, and Covid is not the flu, and it is really scary to think what might happen with repeated infections and new variants.
posted by gudrun at 10:56 AM on September 26, 2022 [8 favorites]


I suspect that among the forever-masking lay public

Do you mind if I ask what epidemiology or medical qualifications you have, since you seem to be contrasting yourself with laypeople, presenting yourself as an expert.
posted by Dysk at 12:33 PM on September 26, 2022 [4 favorites]


I include myself in the laypeople? I am a "not forever-masking lay person", one of the "vaccinated-and-happy-to-be-back-to-normal lay public". I don't know how I gave you the impression I wasn't?
posted by daveliepmann at 12:47 PM on September 26, 2022


COVID-19 Linked With Substantial Increase in Type 1 Diabetes in Children – As Much as 72%
Among the more than 571,000 pediatric patients the researchers discovered that:

Within six months of SARS-CoV2 infection, 123 patients (0.043%) had received a new diagnosis of T1D, compared to 72 patients (0.025%) who received a new diagnosis following a non-COVID respiratory infection, This represents an increase of 72% in new diagnoses.

At one, three, and six months following infection, the risk of diagnosis of T1D was substantially greater for those infected with SARS-CoV2 compared to those with non-COVID respiratory infections. Similar results were reported with patients in the infant to 9-year-old and 10-18-year-old age groups.
posted by hydropsyche at 12:56 PM on September 26, 2022 [5 favorites]




I include myself in the laypeople? I am a "not forever-masking lay person", one of the "vaccinated-and-happy-to-be-back-to-normal lay public". I don't know how I gave you the impression I wasn't?

Because, despite the quotation marks, you never referred to any other laypeople in the comment I was quoting. It came off very much as contrasting your position with that of laypeople, who are "forever-maskers".
posted by Dysk at 1:02 PM on September 26, 2022 [6 favorites]


Perhaps it would be worthwhile to focus on the productive aspect of productive persistence in this matter, not just the persistence aspect.
posted by eviemath at 2:34 PM on September 26, 2022


Association of COVID-19 with New-Onset Alzheimer’s Disease
Older adults with COVID-19 were at significantly increased risk for new diagnosis of Alzheimer’s disease with highest risk in people age ≥85 and in women. Study limitations include potential biases introduced by the observational and retrospective nature of this study and inaccuracy in Alzheimer’s disease diagnosis, which should not substantially affect the relative risk analyses since all cohorts were drawn from the same dataset. Next steps include validation from other data resources, longer-term follow-up, mechanism understanding and examining other types of dementia
posted by MrVisible at 5:23 PM on September 26, 2022 [3 favorites]


You may not have consciously accepted it, but you have certainly lived with these risks all your life. As we all have. What do you believe is unique to covid in this respect?


Covid has killed over a million people in the two or three years it's been in existence.
posted by bleep at 8:30 AM on September 28, 2022 [3 favorites]


According to the WHO, there have been 6.5 million deaths worldwide from Covid. Over a million in the United States alone.
posted by MrVisible at 8:40 AM on September 28, 2022 [3 favorites]


According to the WHO, there have been 6.5 million deaths worldwide from Covid. Over a million in the United States alone.

According to the CDC, there were approximately 50 million deaths worldwide from the 1918 flu pandemic. (Though this estimate may be based on outdated information - there's reason to believe it was only about 17 million -- estimates are complicated.)

Either way the deaths were much higher as a proportion of the population back then. Yet that virus has not gone away. People are still getting infected by it every year -- and some people die of it. How should we respond to that virus? How should it be different from our response to sars-cov-2? And why should the responses be different at all?
posted by OnceUponATime at 10:21 AM on September 28, 2022


Just to not be coy - I think our response to both should be to make vaccination, mask wearing, good ventilation, and staying home when you're sick as easy as possible. Also to better find our public health infrastructure. Those measures help with all respiratory viruses, and should probably exist all the time, not just as emergency measures, because deadly respiratory viruses exist all the time.

Also I meant to put "only" 17 million in scare quotes.

Also even though I think the response to COVID-19 and the flu should be the same at this point, I recognize that a lot more people are still dying of one than the other, and that one has more potential to mutate (if only because it is so widespread) into an immune-escape variant. So I respect that there could in theory be reason to respond to them differently. I just can't think of any actual differential responses I would support right now.

I know, double post. But I have this tendency to play Devil's advocate and then an urge to immediately make my own actual position clear.
posted by OnceUponATime at 10:44 AM on September 28, 2022


All I did was post the accurate death count.

As to what else we could be doing, please see my rant above re: suicide booths.

The devil can advocate for himself.
posted by MrVisible at 11:24 AM on September 28, 2022


The question was you have certainly lived with these risks all your life. As we all have. What do you believe is unique to covid in this respect?

The answer was "COVID has killed a lot of people."

But that's not unique to COVID. Other viruses still in wild have killed more. That is my point.

The risk is still higher right now from COVID than from that strain of the flu (or all strains put together.) But the risk of infectious disease has never been zero and never will be, particularly for the immunocompromised and elderly and otherwise vulnerable. So we need to be quantitative. How low can we actually drive the risk? And what costs are we willing to bear to drive it lower than it currently is? I don't just mean monetary costs -- though blows to "the economy" actually hit the poor the hardest, usually - I mean social costs as well.

I'm just frustrated with this black and white thinking. Either the pandemic is over or it's not. Either the virus is the worst thing in history or it's harmless. Either we're over-reacting or we're completely throwing vulnerable people to the wolves.

I'm pretty convinced that none of the above accurately describes our situation, but I'm unsure where exactly in the vast spectrum of "in between" we currently are, or where we're going, or where we can/should realistically try to go.
posted by OnceUponATime at 11:49 AM on September 28, 2022 [1 favorite]


If there's one thing I've learned from the pandemic, it's that every person has a different idea of what "I'm being cautious!" means, rendering the phrase meaningless.

So I was wondering, when you say "we", what do you have in mind? The ideal "we"? Or something else?
posted by aniola at 12:27 PM on September 28, 2022


COVID is quite distinct from the flu in 2020-2022. In 2020-2022, humans have been living with variants of the influenza virus that caused the flu pandemic of 1918-ish for a hundred years. That’s a fair amount of time for adaptation. So, for example, we don’t currently see as high the rates of sequelae from flu infections as we are seeing from COVID infections. The transmissibility is also quite different, with currently dominant strains of COVID being almost as transmissible as measles, which is a hugely different rate from influenza.

Measures we could put in place to protect from COVID (better ventilation, sick leave, socioeconomic supports in general, better health care accessibility in general, cultural shift to wearing masks in crowded public spaces especially when symptomatic, recognition that the US is part of a global health ecosystem and re-commitment to the relevant actions, etc.) would absolutely also help protect us better from the flu than we have been doing, in addition to protecting from COVID, or from any other airborne virus; and that would absolutely be a good thing because one of the things the current pandemic has highlighted is that we have been accepting higher levels of risk from the flu than was necessary.

But the rates of various factors between COVID and the flu are still significantly different, even though they are both airborne respiratory viruses. And that means that COVID is still a higher risk for everyone than the flu, at present. Which means that there is, indeed, a greater urgency for addressing COVID than for addressing the flu, based on the numbers, at present. Though I would certainly agree that the best way forward is to make sure that our structural responses are made permanent, not just viewed as a temporary crisis response.
posted by eviemath at 1:08 PM on September 28, 2022 [4 favorites]


when you say "we", what do you have in mind?

Me? I mean "we, the American people" mostly (since this thread is ostensibly about Biden's remark), though if anyone has any ideas about what "we, the human race" or "we, the people in this thread" can be doing, I'd love to hear them.

But mostly COVID response has been managed through state and national policies, and I don't even know what state or national policies I want to advocate for right now. (Beyond vaccines/voluntary masking/ventilation/public health funding, which are good in themselves at any time but will make a marginal difference in COVID case rates at this point)
posted by OnceUponATime at 1:13 PM on September 28, 2022 [1 favorite]


bleep, I don't think it's valid argumentation to bring up pre-vaccine, pre-paxlovid death counts in response to "what is unique about covid" in a discussion about current covid risk. The relevant statistics — which frankly I find more difficult to gather than I think they should be — would be severe outcomes (including death, hospitalization, post-viral syndrome, and post-infection sequelae, ideally with some rigor around duration & severity with the latter two) among people who are vaccinated and up to date with their booster shots. In an ideal world those numbers would also include the willing-but-unable-to-be-vaccinated, but I've literally never seen a data set with such labels. Since we're trying to assess individual risk we'd need outcomes by age group at least, and ideally by pre-existing condition.

On the same point, MrVisible, I acknowledge this is a tough topic, but I think it's worth considering OnceUponATime's point about what response we're actually calling for here. I read your rant and I empathize with your situation but I don't see a way forward that is better. I mean, do you agree that our tools are limited? For instance, Dysk's answer above was "masks on public transit". That's still mandatory where I am, and it drives me nuts to see more than half of people complying. When I was in NYC months ago it was even worse. But...I honestly don't know what to do to drive up compliance except draconian enforcement, the drawbacks of which which I think we're all aware of. That sucks! Once we've expressed the fundamental shittiness of reality, I'm not sure what's left: stay-at-home orders, restrictions on private gatherings, dine-in eating bans? I think Biden is right that we're past that, and snarking about "the economy" doesn't do justice to the negative effects of the measures we're talking about. We're running out of both carrots and sticks to drive up vaccination rates, though I think there's still meat on that bone.

I think we have to take seriously the apparent fact that only the most severe NPIs have more than a marginal effect on infection rates. (Put another way: even if everyone masked it wouldn't make much of a difference now. Before, it did.) Plus, even those severe measures 1. wouldn't solve the problem, and 2. would have to be in place indefinitely. We're left with vaccines, ventilation, and research, which I hope we all agree should get more funding and administrative attention.
posted by daveliepmann at 5:15 AM on September 29, 2022 [2 favorites]


(Drat, I forgot to add: the dream data set in my first paragraph would also differentiate by prior infection, because we're seeing encouraging results like "Protection against being reinfected waned over time, but against severe disease did not.")
posted by daveliepmann at 5:24 AM on September 29, 2022


even if everyone masked it wouldn't make much of a difference now. Before, it did

This is unsupported speculative opinion at best.

I vehemently disagree.
posted by Dashy at 5:40 AM on September 29, 2022 [5 favorites]


Well, the CDC has dropped the recommendation for universal masking in health care facilities now, so I guess what I'd want is for the CDC to again recommend universal masking in health care facilities, that'd be nice.

This country can't be bothered to do the bare minimum, even the tiniest little bit, to be merciful to people who are particularly vulnerable to this virus. Or the medical staff who have to deal with it, they're pretty livid

If you're having trouble maintaining the illusion that you're living in a civilized society that cares for its children, elderly, or sick, or even the doctors who care for them, that's not my problem. That's just how things are now.

No mercy.
posted by MrVisible at 6:07 AM on September 29, 2022 [7 favorites]


From American Journal of Preventative Medicine(Nov 2021): Modeling COVID-19 Mortality Across 44 Countries: Face Covering May Reduce Deaths

Results
Average COVID-19 mortality per million was 288.54 in countries without face mask policies and 48.40 in countries with face mask policies. In no mask countries, adjusted average daily increase was 0.1553 − 0.0017 X (days since the first case) log deaths per million, compared with 0.0900 − 0.0009 X (days since the first case) log deaths per million in the countries with a mandate. A total of 60 days into the pandemic, countries without face mask mandates had an average daily increase of 0.0533 deaths per million, compared with the average daily increase of 0.0360 deaths per million for countries with face mask mandates.

Conclusions
This study's significant results show that face mask mandates were associated with lower COVID-19 deaths rates than the rates in countries without mandates. These findings support the use of face masks to prevent excess COVID-19 deaths and should be advised during airborne disease epidemics.

posted by cendawanita at 6:09 AM on September 29, 2022 [4 favorites]


You certainly do come across as confident in your opinions that you at least accurately admit you have insufficient knowledge to support, daveliepmann.
posted by eviemath at 6:22 AM on September 29, 2022 [7 favorites]


I think we have to take seriously the apparent fact that only the most severe NPIs have more than a marginal effect on infection rates. (Put another way: even if everyone masked it wouldn't make much of a difference now. Before, it did.)

How is this a fact?
posted by tiny frying pan at 6:56 AM on September 29, 2022 [3 favorites]


It’s not, as other folks’ links show.
posted by eviemath at 7:39 AM on September 29, 2022 [7 favorites]


Voluntary masking is probably going to have a marginal impact because no one will do it. Mandatory masking will probably have a big impact. But do we want to call for that?

(Edit -- I mean yeah, in healthcare settings, that should probably just be a permanent thing. Don't know why CDC would drop that. But elsewhere?)
posted by OnceUponATime at 8:01 AM on September 29, 2022


While there’s a plague? Yes?
posted by Artw at 8:32 AM on September 29, 2022 [4 favorites]


I honestly don't know what to do to drive up compliance except draconian enforcement

There are a lot of steps short of draconian enforcement.

Why do people not wear masks? Some people just hate them. Some don't have them at hand at a particular moment. Some can't buy many because it's expensive for them. Some don't because of peer pressure, and others don't because of lack of peer pressure. Some associate them with authoritarianism. Some find them uncomfortable. Some wear them but wear lousy ones that keep falling off your nose. Some don't because they don't really understand the benefit. Some don't because, returning to the topic of this thread, they think there's no real need anymore, because the pandemic is over.

Imagine if a country decided to address these points. Heavily subsidize production and import of high-quality kn95-, kf94-, and n95-style masks. Have them made in all sorts of cool colors and prints. Distribute them for free particularly in public areas where you especially want people to wear them, like public transportation and schools and hospitals, and make it cheap and easy (and possibly required) for workplaces to make them easily and clearly available to employees.

Start and actively maintain PSA campaigns educating in clear, unambiguous, and engaging ways about why wearing masks is still important. Have ads driving a few different points: it protects you. It protects others. It's the patriotic thing to do! It's easy. It's cheap. It looks cool. Hell, it's sexy. Every mask makes a difference.

Encourage celebrities like sports stars and singers and leaders to advocate for masks. Issue special celebrity-endorsed masks, help masks become a bit of a fashion item.

That country wouldn't get to 100% compliance, but I would bet that it would see higher compliance than what you've got in most countries today.

And that country, being a country that's got it together, would simultaneously be investing in ventilation and research and labor regulations and data collection and welfare support, and launching similar campaigns for increasing vaccine uptake, because that's how you actually get to the point of manageably living with a virus.
posted by trig at 8:34 AM on September 29, 2022 [9 favorites]


I think we have to take seriously the apparent fact that only the most severe NPIs have more than a marginal effect on infection rates. (Put another way: even if everyone masked it wouldn't make much of a difference now. Before, it did.)

How is this a fact?
tiny frying pan, I already posted a link in a comment saying "we're arguably past the stage where non-draconian restrictions are effective", which briefly makes the case that "masking, ventilation, and [moderate] social distancing would lead to only a fairly negligible (~10%) reduction in prevalence". Maybe I'm misapplying it to the context of our discussion but fundamentally what I'm asking is that given this extremely transmissible respiratory virus, how and to what extent do folks think that we can restrain it or otherwise protect folks who are still vulnerable?

I contend that Cendawanita's study is not really applicable now, because compliance with mask mandates has plummeted as vaccination and prior infection rates have grown. So what is the proposal, and what are the expected benefits? Dysk brought up masks on public transport, and I think I addressed that. MrVisible raised masks in health care facilities, which is fair — it's the law where I am, and I agree with it for the time being.

Trig proposes a major mask messaging campaign, which answers my "how" question but not "to what extent" would it help. So I would love to read people's estimates, meaning: how much spending for how many people's changed behavior for how much change to which covid metrics. I'm eager for even your back of the napkin guesses, because mine all conclude with "very very little effect because going from 40% to 60% for people masking on the subway doesn't much slow the spread". Me, I'd spend that effort on vaccine messaging, carrots, and sticks instead.
posted by daveliepmann at 9:04 AM on September 29, 2022 [1 favorite]


I don't know which link you are referring to. I don't do "back of the napkin" estimates, either. We aren't qualified to be evaluating statistics off of articles or comments about various studies.
posted by tiny frying pan at 9:10 AM on September 29, 2022


What is the question?
posted by tiny frying pan at 9:29 AM on September 29, 2022


Your "arguably" link is to a Twitter thread?

I am asking what is the question because you seem absolutely driven that lay people answer *something* about how directives which would help the pandemic are now useless and I'm struggling to figure out why we need to evaluate that measures like masking are no longer helpful (especially since we know they are - helpful to people in this room, even!).
posted by tiny frying pan at 9:32 AM on September 29, 2022 [2 favorites]


Wow, the heartlessness of a few posters here.

Hey, I have an idea! Why don't y'all show up to Dave Lunn's funeral and say, "welp, I couldn't be bothered to advocate and do my part for people who aren't healthy as me! Whoopsie!"
posted by Kitteh at 9:48 AM on September 29, 2022 [5 favorites]


Yeah, that's what I'm wondering too. Because the people who want us to be doing nothing have won. All restrictions are off, it's a goddamn free for all, and the vulnerable among us are left to try and make something of our lives in a society that's written us off as unprofitable.

It seems like a couple of people in this thread just want to be able to feel better about that, as if there was no choice, as if there's some kind of reasonable argument for throwing our weak to the wolves. They want to pretend there was nothing we could do, despite other countries having successfully done so much more. They want absolution.

I'm sorry, but if you're on board with the whole 'people should die for the sake of the economy' bullshit, you should feel bad. That little voice inside you that's telling you that what you're doing is evil, is right. You've chosen this. You'll have to live with it.

These decisions put the lives of old people, sick people, children, the most vulnerable members of our society at risk. These decisions destroy lives, and you're on board with that.

But please, feel free to cough up whatever sealioning nitpicky bullshit you use to try to assuage your conscience again, that's always entertaining. But don't expect absolution from me. You're okay with killing people on a grand scale, for money. Cope with that your own damn self.
posted by MrVisible at 9:48 AM on September 29, 2022 [12 favorites]


Also, I literally work in healthcare. If you rock up without a mask in my clinic, you will be asked to put one on or leave and have a remote doctor's appointment.
posted by Kitteh at 9:49 AM on September 29, 2022 [4 favorites]


But, but, getting to make my own decisions about risks I’m willing to take on is only for stuff like public health measures that inconvenience me, and where the negative impacts of my riskier choices only affect other people and prevent them from having the option of making lower risk decisions; not for stuff like me having to deal with the social consequences of being all dismissive and condescending toward fellow commenters who have specifically mentioned being - or having loved ones - in higher risk groups, or ignoring the links to valid science provided repeatedly by more knowledgeable fellow commenters!

/hamburger
posted by eviemath at 9:57 AM on September 29, 2022


Covid 23 hasn't come out yet. Covid-19 is still the problem at hand.
posted by bleep at 12:47 PM on September 29, 2022


Mod note: Another "dictionary says" comment deleted. Note that this is directly against the Community Guidelines.
posted by loup (staff) at 12:53 PM on September 29, 2022


I'm sorry I have to make another comment but please god, "Since we're trying to assess individual risk we'd need outcomes by age group at least, and ideally by pre-existing condition"
We keep going back and forth - when we say individuals should consider they're at risk, it's "You can't prove there's a risk. It doesn't look risky to me." When it's ok fine, forget individual risk, we need to stop the spread, it's"There's no point! It's hopeless!"
This isn't a productive mode of approach to literally any problem. If you think there's no risk & no point doing anything about it, why sit on a thread arguing about it??? What is there to gain??
posted by bleep at 1:02 PM on September 29, 2022 [5 favorites]


Honestly I don't care if they ban me for saying this, what you're supposed to do when you don't care about a thread is you skip it, not camp out gaslighting & shooting down & gaslighting anyone who has any reason to give a crap. I think it's pathetic AND twisted.
posted by bleep at 8:54 PM on September 29, 2022 [2 favorites]


bleep, I admit that I think individual risk assessment and mitigation policy evaluation are 1. distinct and 2. necessary to decide on a response to the situation.

Yes, I think a discussion about individual risk assessment should take into account the variables listed. I'm kind of flummoxed as to what is controversial about that? I agree with you that it's weird that the conversation repeatedly derails to & from individual risk and community policy.

What you take as "it's hopeless" is, it seems to me, mostly my saying that a discussion about covid mitigation policies should distinguish between early 2020 and late 2022 (i.e. pre/post vaccines, health systems at risk of overload, Evusheld, Paxlovid, etc.), and should consider trade-offs regarding efficacy and implementation challenges. Otherwise we're just venting, which I get is popular, but it's not the only way to participate in this discussion.

I do not think that "there's no risk & no point doing anything about it", and if you think that's what I'm saying then I think a major reason for our communication breakdown is that you haven't read what I've written. About half of my comments in this thread include explicit support for specific policies, and my comments about risk are generally about different risks for different groups. We just draw the "mitigation policy worth supporting" line at different places. (On that I think we, myself explicitly included, could do a better job not embodying that George Carlin line, "everyone going slower than you is an idiot, and everyone going faster is a maniac".)

Following that line of thinking, I think many folks are not acknowledging that they too are "evil" according to MrVisible, in that they're opposed to PRC-style no-covid lockdowns, even though they would give a few months of protection to folks in high-risk groups. That's why I've asked commenters to state the policies they're in favor of: unless you are in favor of draconian measures for the foreseeable future, we stand together in his "evil" category. I'm reminded of that old joke with the punchline, "Madam, we've already established what you are. Now we are merely haggling about the price." Being in favor of renewed mask mandates but not permanently eliminating dine-in restaurants is haggling over the price.
posted by daveliepmann at 1:15 AM on September 30, 2022


Regarding why I'm in this thread at all, one, I think the discussion is worthwhile on its own, and I like to explore these ideas with other people. Two, I see a lot of people in a situation like this ask, and my heart breaks for them. A lot of people are struggling so hard because they're bombarded with irresponsible messages [1] and find themselves stuck between two terrors: doing the wrong thing and hurting others, and living forever in isolation.

To the extent that I think more accurate information can help people in that position, I think discussion is worth it. To the extent that I contributed to creating their terror by being an early adopter of masks and isolation, I think I have a responsibility to walk people back from continuing to live that way after circumstances have changed.

[1]: I mean things like "repeated infections will never wane in severity", "we don't need to update risk assessments in light of pharmaceutical interventions", insisting that covid is unique and cannot be compared to other risks, insisting on making masks a permanent part of the US culture war (and thus shaming anyone who mentions drawbacks or questions their efficacy compared to other tools)
posted by daveliepmann at 1:46 AM on September 30, 2022


irresponsible messages [...] I mean things like [...] insisting on making masks a permanent part of the US culture war

Sounds like you've decided that any measures you aren't personally in favour of are "draconian" and a sign that the person espousing them are a bad person. You're doing exactly what you're accusing everyone else of.
posted by Dysk at 1:59 AM on September 30, 2022 [8 favorites]


I don't think that's a fair reading of what I wrote. I don't categorize masks as draconian, I haven't insinuated anyone is a "bad person" (!?), and I've voiced support for ongoing German-style mask mandates in specific contexts. What are you on about?
posted by daveliepmann at 2:22 AM on September 30, 2022


You've declared viewpoints draconian and irresponsible, and literally listed making masks part of the US culture war as any example of the latter. Like, those are literally things that are in your comments in as many words.
posted by Dysk at 2:30 AM on September 30, 2022 [4 favorites]


I believe you have made a reading comprehension error with regards to me applying "draconian" to "masks". I apologize to the extent that I was unclear. In a recent comment I used the former term to contrast mask mandates with tactics both more effective and more stringent (e.g. an permanent indoor dining ban). And earlier in the thread I discussed the troubles with draconian enforcement of mask mandates. It might help for me to share that during the acute phase of the pandemic (read: pre-vaccines, everyone at moderate individual risk or higher, health systems at serious risk of overload) I had many fantastical daydreams that we could renew the 1918 pandemic strategy of sending gangs of young men through the train to beat maskless travelers with truncheons. But 1. the fascist tones of such a tactic make me question its ethical validity, 2. escalating violence is probably a bad idea in a practical sense, and 3. I don't believe this has been a modern covid mitigation technique anywhere in the West.

My view is that one side of the US culture war rejected masks when we were in crisis and masks were one of our best tools, and that was shitty, irresponsible, innumerate, and unsolidarisch of them. However, the other side of the US culture war now struggles with the decision to either continue fighting the mask battle of 2020 or to let it go in light of the fact that other far more effective tools are widely available, the risks (to individuals, and of health system overload) are far lower, and achieving effective levels of compliance seems unfeasible.
posted by daveliepmann at 3:01 AM on September 30, 2022


There aren't really other, far more effective tools for reducing the spread, though. It's an incredibly effective tool.
posted by Dysk at 3:18 AM on September 30, 2022 [5 favorites]


even one-way masking is better than no-masking, no? in concert with other policy and social measures, why masking specifically is being treated like there's no point committing to it individually even as it's being done imperfectly socially? USA as a country already has poor vaccination uptake rates, where in some places you can make the argument it's almost like there's been no vaccination at all, and infection-induced antibodies doesn't seem to confer protective quality at the same rate. So in those areas, masks remain, as you say "one of our best tools".

the bad news, such as it is, is simply this: even with mass vaccination (which at population-level is already poor), even with improved ventilation (which as policy-level is not seriously pursued), even with better working policies (which I'm told is basically a non-starter), much of your environmental considerations in the US remains pretty much the same that masks is basically still part of your toolkit. Imperfectly.

and why argue on the basis of culture when it comes to compliance as though it's one feature of human society that is not extremely flexible and contingent? are people now being radicalized into unfeasible civic behaviours? sure. that seems to prove my point that cultural conditioning is in fact an extremely viable lever for social change.
posted by cendawanita at 3:19 AM on September 30, 2022 [8 favorites]


There aren't really other, far more effective tools [than masking] for reducing the spread, though. It's an incredibly effective tool.

1. Forcing people to isolate is a far more effective tool than masking for reducing the spread. I would call it both incredibly effective and draconian.
2. My judgment is that masking is not incredibly effective in a context where the virus is already widespread and people engage in normal activities like restaurant dining and unmasked in-person work and leisure. I beg for someone to post any kind of estimate for how much change we could expect to see in measures like prevalence or severe outcomes based on a realistic renewed masking norm. Balloux's estimate in the link I posted above is -10% prevalence, based on Kucharski's model and assuming transmission is reduced by 50% through NPIs like masking. He notes that this 50% is quite optimistic/challenging. I'm not saying these numbers are the truth but they're a starting point for discussion. Personally I'd say -10% is not "incredibly effective" and therefore I doubt it's worth the effort, given the other tools we have. Folks who think I'm a monster for this opinion, please at least distinguish between "-10% is worth it" and "-10% is a low estimate of the effect" and "prevalence is the wrong metric; we should be optimizing X".

Cendawanita, population-level vaccination where I am is rather good, though as I've said many times I think this is one of the techniques with the best return on investment and we should be doing more, because pressure on the health system continues to be too high. Re: infection-induced antibodies, what I've seen is that protection against reinfection is low but against severe outcome is high; this was the content of my discussion with sciatrix above. I'm open to other evidence as long as it's not that widely-misreported US veteran reinfection study.
posted by daveliepmann at 4:00 AM on September 30, 2022 [1 favorite]


If people insist on eating indoors and otherwise carrying on like the pandemic doesn't exist, the least they can do is wear a mask when out in society to protect the rest of us from the choices they're making. I don't understand what's complicated or hard about that. You get to live your life exactly as you want, except when you're on the bus, in the grocery store, at the doctor's office, at church, or anywhere else that people at risk might be, you wear a mask. There is plenty of science to support the benefits of two way masking. Wear a mask.
posted by hydropsyche at 4:07 AM on September 30, 2022 [8 favorites]


Forgot the blockquote:
We find, for a typical SARS-CoV-2 viral load and infectious dose, that social distancing alone, even at 3.0 m between two speaking individuals, leads to an upper bound of 90% for risk of infection after a few minutes. If only the susceptible wears a face mask with infectious speaking at a distance of 1.5 m, the upper bound drops very significantly; that is, with a surgical mask, the upper bound reaches 90% after 30 min, and, with an FFP2 mask, it remains at about 20% even after 1 h. When both wear a surgical mask, while the infectious is speaking, the very conservative upper bound remains below 30% after 1 h, but, when both wear a well-fitting FFP2 mask, it is 0.4%. We conclude that wearing appropriate masks in the community provides excellent protection for others and oneself, and makes social distancing less important.
posted by hydropsyche at 4:09 AM on September 30, 2022 [4 favorites]


1. Forcing people to isolate is a far more effective tool than masking for reducing the spread. I would call it both incredibly effective and draconian.

This is both not more effective in practice, as it is near impossible to enforce. You cannot easily tell if someone has covid. Mandatory testing is trivial to sidestep, inputs implemented in the most awful way possible. It's also irrelevant, as nobody is arguing for that. It's not meaningfully a toll at our disposal, at least not in a form where it is effective.

You can easily tell if someone is wearing a mask. It is very effective at stopping transmission. Sure, the virus will still circulate and it will not eradicate it population scale, but it allows people to actually manage their own risk and does in fact reduce population scale effects.

But then, this isn't my first rodeo, and I lived through mandatory masking in Hong Kong (where asthma was incredibly common, and yet everyone managed) for SARS (the first one, not this sequel) and so this neither feels like a massive violation of my rights or pointless.
posted by Dysk at 4:18 AM on September 30, 2022 [9 favorites]


Look, I'm glad your particular area seems to have satisfactory levels of vaccination. But you must also know vaccination needs a certain threshold of population uptake before it can mean something in terms of calculating overall risk. An area-level stats mean nothing if there's no border control (simply in terms of controlling for vector spread). That's among the reasons why you look at vaccination at national-level, or like Australia, when states were fully closed to each other, state-level. It's not a magic amulet. The less likely it can fully exert population change the more important it becomes to supplement it with other measures. Many countries accept the relaxation of social distancing once they hit a satisfactory level of vaccination by population. I do understand the US did the first with no consideration of the second.

Protection against severe outcomes is also good, though of course one would want to avoid (re)infection as much as possible. I'm still unclear why masking in particular seems like such a heavy ask. In fact, such a heavy ask that not only are you reluctant to employ them yourself, you also want to advocate to others to let it go and stop masking? Asians weren't born with the genetic predisposition to love masking btw. Yet, frequently I detect a note of intense sorrow and terror here (and elsewhere with similar profiles). Like you can't socialise somehow? Or conduct your daily life. Maybe it's because I'm a Muslim woman and you know how we super-enjoy veiling ourselves and somehow managed to live in public. /s
posted by cendawanita at 5:15 AM on September 30, 2022 [5 favorites]


But then, this isn't my first rodeo, and I lived through mandatory masking in Hong Kong (where asthma was incredibly common, and yet everyone managed) for SARS (the first one, not this sequel) and so this neither feels like a massive violation of my rights or pointless.

And this is where the rubber meets the road. While not exclusively restricted to North America, Americans are very vocal about "oh noes mah rights are bein violated", even folks who were generally pro-mask in the beginning. It's this willful refusal to give a shit about anyone else that irks me. The eagerness to throw vulnerable people under the bus so long as they have their "normal" lives. Not to mention how COVID is impacting communities of colour, and people on minimum wage who need to work and can't stay home sick to serve folks their precious bottomless mimosas, plus many other people that white middle class people just can't relate to.

Because what's becoming clear to me that the response to COVID is now very very clearly racialized as well as income. The biggest voices I see whining about half-assed to nonexistent preventative measures are people who were able to WFH during lockdown, which often translates to a level of privilege which often equals white.

And the disingenous poster asking us--ordinary folk--to give concrete examples of change that wouldn't affect their precious social lives? You know who you ask? Your fucking elected officials. You ask them how they are going to protect us because right now we are left to protect ourselves and we should NOT have to be doing that during an ACTIVE pandemic.
posted by Kitteh at 5:17 AM on September 30, 2022 [6 favorites]


Sorry to add a second comment so soon, but the reason why I get het up about this is because I work in healthcare. I see how the pandemic affects patient care everyday and to say that it is over is an insult to everyone in healthcare who worked so hard to do our best to protect the public.
posted by Kitteh at 5:35 AM on September 30, 2022 [6 favorites]


I'm still unclear why masking in particular seems like such a heavy ask. In fact, such a heavy ask that not only are you reluctant to employ them yourself, you also want to advocate to others to let it go and stop masking?

I'm actually much less concerned about masking than I am about risk misinformation and indefinite social isolation. (If you read above, it's what got me into this thread. Masks were a much later side discussion for me.) Realistic risk assessment is important to me and I think people who overestimate the threat to them based on misinfo deserve better. This often leads to comparing costs and benefits of various interventions, which leads to mentioning my preference for high-ROI measures like research funding and improving vaccine uptake.
posted by daveliepmann at 5:51 AM on September 30, 2022 [2 favorites]


Even if it was initially a side discussion, my read is that the fundamental disagreement is clear: you don't consider masking as also a high-ROI measure. As well as the measure that could actually be practiced on individual basis. At best, you consider it as outdated as social isolation? I don't find the rhetorical concession that this behaviour is going to be another part of "culture war" particularly persuasive in thinking about stopping the practice. I would've thought the opportunity then is to normalize it. And like better ventilation and unlike vaccination, it's a measure that helps to reduce one's susceptibility to other diseases. As a cultural habit it's not the worst ask.
posted by cendawanita at 6:01 AM on September 30, 2022 [5 favorites]


I mean things like "repeated infections will never wane in severity",

We literally do not know what repeated infections will do to an individual person - sometimes, these outcomes are bad. We also cannot bank on a separate issue - that any initial infection with a mutated virus will be a less severe disease then we've seen so far.
posted by tiny frying pan at 6:58 AM on September 30, 2022


tiny frying pan, did you see the excerpts I linked to of the paper which found that prior infection was highly protective against severe outcomes? If more evidence comes out supporting that hypothesis, would it change your behavior?

cendawanita, I think I consider masking less outdated than social isolation, because I'm in favor of a cultural shift toward everybody wearing a mask when they have a sniffle. At the same time, while I understand the reasoning behind my city requiring them on public transit, I think keeping the rule is a net harm, because widespread noncompliance undermines public trust and compliance with future measures. You don't want to train your citizens to ignore the rules.

As for whether it's a high-ROI measure, well, in early 2021 my city skirted right up against the edge of health system overload, and stayed there for a while. Masking was definitely high-ROI then — it made the difference, saving us from bodies piled on the streets and people turned away from the ER! I'm proud that we Berliners stood together to do that. Whether masking is a high ROI measure now depends on whether you think reducing prevalence by a few percent is worth the drawbacks, taking into account that infection has been largely de-fanged and it's everywhere and it's not going away. I see that last one weigh heavy in a lot of people's AskMe posts – a lot of people are staring at their current measures thinking, "is this forever?"

Dysk, just a clarification: I meant "forced isolation" like "PRC lockdowns", not "a rule to stay home for a week after testing positive". My bad.
posted by daveliepmann at 8:20 AM on September 30, 2022


I mean things like "repeated infections will never wane in severity",

We literally do not know what repeated infections will do to an individual person - sometimes, these outcomes are bad. We also cannot bank on a separate issue - that any initial infection with a mutated virus will be a less severe disease then we've seen so far.


So then you agree that the assertion is fundamentally incorrect and unhelpful. It's just as incorrect as saying "repeated infections will always wane in severity."
posted by We put our faith in Blast Hardcheese at 9:00 AM on September 30, 2022


I don't know what you think my "behavior" around covid is, daveliepmann. But I'm not discussing myself or my life in this thread.

What assertion, Blast? I don't see that in this thread. I don't think this discussion is productive when there are all these straw arguments. I don't think anyone argued that repeated infections will always lead to bad outcomes.

There's a real tone of attempts at "gotcha" here that I feel is very off-putting. And a strange insistence that people concede something.
posted by tiny frying pan at 9:07 AM on September 30, 2022


I'm sorry I came across as intrusive, comrade frying pan. All I meant by it was to ask about your thinking. Where I come from this is how to politely explore a topic where people have different perspectives — no "gotcha".
posted by daveliepmann at 9:32 AM on September 30, 2022


I think once again a problem with these conversations on metafilter is that some folks approach it as "nobody in this thread is saying X" when the original person means, "people in the world/in media/on Twitter/at large often say X."

Nobody here argued that repeated infections can't ever wane in severity. But there are a lot of voices in the Greater COVID Internet that do, often because they are simply trying to condense or simplify, and sometimes because they would like to shock people out of a perceived complacency. I would agree with daveliepmann, if i'm reading them correctly, that it does no good to flatten the nuance of the situation in the service of EITHER cause.

I think it's pathetic AND twisted.

But honestly once we've gotten to the active namecalling stage it's probably not worth pursuing any further.
posted by We put our faith in Blast Hardcheese at 9:36 AM on September 30, 2022 [2 favorites]


At the same time, while I understand the reasoning behind my city requiring them on public transit, I think keeping the rule is a net harm, because widespread noncompliance undermines public trust and compliance with future measures. You don't want to train your citizens to ignore the rules.

And i think this is where western public health strategies really need to learn from their non-western cohorts. Fwiw even here all indoor masking mandates are relaxed to 'recommendations' ie no longer a fineable offense. Just today the announcement is that there's no need to wear them in flights though it's recommended for those with high-risk profiles and if you're flying to a stricter country you should abide by those rules. Still, people do mask. Not 100% compliance but it's there. More crucially no one judges you either way -- in fact it's those who fuss about having to interact with a person masking that gets the sideeye. And the "few percentage points" is not a small thing at least in terms of manifold impact at population level. I've mentioned how it's useful measure for other diseases -- over here people wear it when they feel that THEY'RE getting a bit sick as they move about in public spaces. And certainly for less infectious coughs this is actually a terrific practice at population-level. Certainly we've got evidence certain flu variants are functionally extinct as they're no longer transmitted due to this practice.

Sincerely i do feel westerners make too much of a concern about masking as a long-term adaptation. At this point if you are of decent health where COVID is a slight inconvenience should you get it, why not keep wearing masks so those who couldn't wear them or even as they continue to do so are just at a higher risk due to their own personal immunity situation don't have to gamble with their own risk registers as the world opens up again? If you could at least "sacrifice" the pleasure of bequeathing the world your smile for a few more years, we might be able to get somewhere.

And consider those who are hard of hearing and deaf who's had to compromise THEIR quality of life in the last couple of years if they had been depending on lip reading. Don't you want to get the world to a point where their preferred accommodation doesn't impact on someone's actual long-term health prognosis?

Belated thought about law abiding norms: i guess the 'nice' thing coming from the global south is that we never really lived a life where the rules just make sense. Consider the levels of endemic corruption here (i mean, Scorsese got a movie out of it). We break laws all the time. Yet, we somehow could mask because we could see the point? Hell, when the govt initially moved slowly (because CDC/WHO moved slowly) we broke the norms with clusters quickly mobilizing to mask each other. People act according to their own morals, so my contention is, norms being so contingent, take this opportunity to make masking normal. So, take that as a cynic's comment on the supposed sacrosanct laws that would erode public trust.
posted by cendawanita at 9:38 AM on September 30, 2022 [10 favorites]


If you could at least "sacrifice" the pleasure of bequeathing the world your smile for a few more years, we might be able to get somewhere.

What I, and I think daveliepmann also, are asking is: WHERE ARE WE TRYING TO GET, and WHAT ARE THE ACTUAL, PLAUSIBLE ODDS OF US GETTING THERE. "In a few more years, maybe, possibly, because who knows, anything is possible in this wild world" isn't enough to drive widespread public policy, or at least not in the United States from any evidence I've seen thus far.

Also though if anyone has any tips on not getting blinding headaches from the masks, every single time, I would be here for that, because honestly it is a lot, and never gets any better with continued use?
posted by We put our faith in Blast Hardcheese at 9:51 AM on September 30, 2022 [1 favorite]


Public policy seems to be quite difficult because there seems to be no social traction so in my small way I'm recommending normalization of mask usage customs. Again, this seems to be a cri de coeur that doesn't rate much attention here and it's useful to consider why. People mask well before this particular disease, not to mention due to pollution/capitalism-related phenomenon reasons (haze season here; sand season in east asia), and maybe quite bleakly, you're more likely to find people staring at that question ('WHERE ARE WE TRYING TO GET, and WHAT ARE THE ACTUAL, PLAUSIBLE ODDS OF US GETTING THERE.') in polite confusion. Maybe in this way, we're the ones who are actually quite libertarian, taking measures in our own hands.

Regarding the headaches, i have 2 responses:

1. Have you considered not using the elastic strap and instead use surgical tape to the sides? This suggestion assumes the tension comes from the pulling against the ear and switching to head loops make no difference.

2. If the rate of masking is high enough, then like vaccination, you could depend on the kindness of your fellow humans and be a little lax there because you genuinely have a medical issue about it.
posted by cendawanita at 10:02 AM on September 30, 2022 [1 favorite]


the "few percentage points" is not a small thing at least in terms of manifold impact at population level.

I don't follow. Assuming I'm right that this coronavirus is largely like other coronaviruses save its novelty, endemicity means that everyone is going to get it over and over and over. (And thank goodness we have vaccines and paxlovid and monoclonal antibodies and so on to make infection not super-dangerous and reinfections even less dangerous). Where's the manifold impact of a <10% reduction in prevalence? It's an honest question, I'm open to the idea that I'm missing something. Are you still playing "flatten the curve"?

I also completely don't follow your point about the hard of hearing. What point are you waiting for the world to reach?
posted by daveliepmann at 10:06 AM on September 30, 2022


No, flattening the curve is a ship long sailed in some countries. While in others it seems to be possible once you adjust where the curve should be. What i mean to say is that reducing prevalence by a few percentage points (while itself is not yet validated) can still have manifold impact in terms of reducing the impact to public healthcare (people are less likely to be sick by this specific disease that does take up the resources that could be used for others) and labour market (people aren't on medical leave at rates that impact productivity) and economy (causing a downturn in the GDP etc etc). This is of course trying to draw up a theory of change over why masking can have development dividends. Even besides all that you can consider how the R-rate (rate of infection) is calculated - from my understanding it's not a linear calculation. So if it's logarithmic, a well-situated intervention can have a wider effect.

Please note, I'm going to go to sleep now and i would probably try my best to not comment further. At this point the discourse is well-trodden. I have my motivated (evidence-based) reasoning to keep masking, from a region who have been masking, and you are skeptical of them. That's fine. So while i can wait for those who are culturally unused to it to get used to it on their own timeline, i don't have to be the one carrying the conversation. This is now between those who are in societies where not only masking is being made to be weird but also politicized.

For the hard of hearing and as it will show, others: i want to get to the point where the world can conduct itself without needing masks in all interactions. Perhaps we are getting to the point where limited interaction to a person outside your bubble is possible, where this isn't going to cause a spike in risk in getting infected. We have the first, but the second doesn't necessarily follow in many places. When this can be possible the deaf community and the hard of hearing wouldn't have to struggle on the ethical compromise that we as a society have burdened them with. And if the now-extinct flu variant can be made an example (that took 2 years and was an accidental outcome of COVID masking), then mass masking might not have to be as long a commitment as someone's mortgage. Of course with the way it is now maybe it'll be around when our children needs to start thinking about their mortgages.
posted by cendawanita at 10:37 AM on September 30, 2022 [5 favorites]


Perhaps the commenter who claimed that they called COVID-19 “spicy cough” in order to get the folks in the thread who are at higher risk to think more about folks at lower risk from COVID has not demonstrated the best understanding of the dynamics of social influence or cultural change among humans. Or is not entirely arguing in good faith.
posted by eviemath at 3:50 PM on September 30, 2022 [10 favorites]


I’m worried that even the interventions that have broad consensus (at least in the reality-based community) are falling by the wayside. Please talk to your friends and family about boosters! Don’t just assume they will hear about it on their own.

A study published today found that only about one third of US adults have gotten or plan to get the updated booster; only about half have even heard about it. Even here in Seattle, where about 90% of people got the initial round of vaccines, about half the population have never gone back for any booster.
posted by mbrubeck at 6:18 PM on September 30, 2022 [7 favorites]


Mod note: One deleted. daveliepmann, it's beyond time for this thread to cease being all about you. You've made your points, repeatedly; time to let other people discuss without having to answer to you.
posted by taz (staff) at 11:02 PM on September 30, 2022 [6 favorites]


Assuming I'm right that this coronavirus is largely like other coronaviruses save its novelty, endemicity means that everyone is going to get it over and over and over.

That's a hell of an assumption, not least considering that you've seemingly misunderstood endemicity. It means the virus remains in circulation at a steady level, not that everyone gets it over and over. Flu is endemic, but it's not like everyone catches it every year. I know people that haven't had it for years and years (and who would, thanks to their immune status, very much finde out if they did). It's entirely possible for something to be endemic and still avoidable on an individual level.
posted by Dysk at 12:27 AM on October 1, 2022 [6 favorites]


So it's come up a couple times in this thread and I want to be clear: there's exactly one person here who's said positive things about the way that China has handled the pandemic. It was me. I'll stand by that still, but if you're trying to lay that at the feet of literally anyone else in the thread then you're off base and need to be more careful about what it is that you think the people you're arguing against are actually advocating. It does no benefits to me, you, or anyone else to confuse the issue that way.

On a different note, I just today discovered People's CDC which seems like a lovely resource, which probably other people already knew about but I didn't. So I figure'd I put the link in the thread here.
posted by vibratory manner of working at 12:36 AM on October 1, 2022 [5 favorites]


Also though if anyone has any tips on not getting blinding headaches from the masks, every single time, I would be here for that, because honestly it is a lot, and never gets any better with continued use?

I got one of those "chemo turban hats" & I tuck my hair into that & it cushions the straps so they're sitting on the hat & not on my body. Helps a lot.
posted by bleep at 3:24 PM on October 1, 2022 [2 favorites]




Sorry, link accidentally goes to a comment but it's the right thread.
posted by tiny frying pan at 6:08 AM on October 2, 2022 [1 favorite]


Ed Yong of the Atlantic has written a piece that ought to be a part of this thread:

"The Pandemic’s Legacy Is Already Clear: All of this will happen again."
COVID still kills roughly as many Americans every week as died on 9/11. It is on track to kill at least 100,000 a year—triple the typical toll of the flu. Despite gross undercounting, more than 50,000 infections are being recorded every day. The CDC estimates that 19 million adults have long COVID. Things have undoubtedly improved since the peak of the crisis, but calling the pandemic “over” is like calling a fight “finished” because your opponent is punching you in the ribs instead of the face.
[...]
America experienced the largest life-expectancy decline of any wealthy country in 2020 and, unlike its peers, continued declining in 2021. If it had fared as well as just the average peer nation, 1.1 million people who died last year—a third of all American deaths—would still be alive.

America’s superlatively poor performance cannot solely be blamed on either the Trump or Biden administrations, although both have made egregious errors. Rather, the new coronavirus exploited the country’s many failing systems: its overstuffed prisons and understaffed nursing homes; its chronically underfunded public-health system; its reliance on convoluted supply chains and a just-in-time economy; its for-profit health-care system, whose workers were already burned out; its decades-long project of unweaving social safety nets; and its legacy of racism and segregation that had already left Black and Indigenous communities and other communities of color disproportionately burdened with health problems. Even in the pre-COVID years, the U.S. was still losing about 626,000 people more than expected for a nation of its size and resources. COVID simply toppled an edifice whose foundations were already rotten."
This is a concrete list of measures we could take to deal with COVID at this point... Reduce healthcare costs. Shore up the "care economy." Break out "school to prison pipeline." Build a robust domestic manufacturing sector. Build social safety nets, and remove racial disparities in our society. Unfortunately, they're the same measures we need to take to deal with nearly all of our other national problems, and we've been unable to implement them so far because of tragedy of the commons stuff that we don't know how to solve.
posted by OnceUponATime at 3:49 AM on October 3, 2022 [8 favorites]


As someone that worked in a grocery store full-time from the beginning of the pandemic through last fall, I'm glad I'm not being forced to mask up anymore. During the the stricter lockdown periods of the pandemic with mandatory mask and maximum occupancy rules, we tried our best to protect as many people as possible.

In return, my coworkers and I were physically assaulted, verbally abused, and spit on frequently. Requests for law enforcement help were met with laughter and derision. At this point, even if there was a government mandated mask rule again, I'm fairly certain that the store I worked at wouldn't enforce it. It's not worth the danger we'd be placing ourselves in.

If you feel so strongly about it, then be prepared to enforce it yourselves because many of the people that had to do the enforcing the first time around are pretty checked out and probably not interested in enforcing anything ever again.

Mask mandates would be the perfect solution in a dream world not populated with assholes...
posted by schyler523 at 6:24 AM on October 3, 2022 [7 favorites]




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